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?

Give and take away

Be careful what you ask for
Before I went to sleep on Sunday night, I asked, "God, can give me more motivation and make me more hardworking ar? Coz I felt as if I am being lazy and have not been doing much work.. The next day, a new consultant turned up in the ward and start bombarding me with quizzes and questions on basic and clinical sciences. Some I know the answer to (and managed to dodge), others I need to look up. And he did that for ALMOST every patient - My goodness, that was the LONGEST ward round in a while..

Prayer development ministry
Thankful that I went. Know your identity and in whom you find your security.

Oceania Convention 2010
Gold Coast in 2 days time. Heart preparation required.

It's a bitter pill to swallow..
..when you realise that you won battles but not the war.. when something you thought had gone well in the past did not turn out as expected when you reviewed it a second time around. Felt like one of the pillars of strength which you have built on all this while, suddenly being reduced to dust. Nevertheless, there were several reasons for me to feel upset, but delving deeper to the root of the problem, it took a song on the train ride home to serve a gentle reminder - (the lyrics speak for themselves) and also to give thanks in all circumstances.

Currently listening: Laura Story - Bless the Lord

Verse 1
You give and take away for my good
For who am I to say what I need
For You alone see the hidden parts of me
That need to be stripped away

Verse 2
And as You begin to refine
I'm learning to let go and rely
On One who walks with me
As hard as it may be
You're teaching me all the while to say

Chorus
Bless the Lord, O my soul
All that's in me bless Your name
Forget not Your power untold
Not Your glory or Your fame
For You came to heal the broken
To redeem and make me whole
Bless the Lord, O my soul

Bridge
Though my faith may falter and my strength may fail
I pray for eyes to see
The richness of Your mercy shown to me
Bless the Lord, bless the Lord

Sometimes I wonder; why do I keep having things which I am beginning to hold dear to taken away from me? So much so that at times I'm upset of having to start over from scratch..again, especially when this year has been a challenge. One more transtion period to adapt to for the umpteenth time.

Whatever the case, I will uphold it unto You. If it needs to be done. Coz the theme surrounding QT for the past few days has been to trust and persevere (Connect Journal Day 6 on Matthew 2:13-23; What is God reminding you about the level of trust and guidance He promises to provide over your life?) But I really need understanding..

Addendum:

Psalm 46:1-3
God is our refuge and strength, an ever-present help in trouble. Therefore we will not fear, though the earth give way and the mountains fall into the heart of the sea, though its waters roar and foam and the mountains quake with their surging.

Psalm 121:1-2
I lift my eyes to the hills - where does my help come from? My help comes from the Lord, the Maker of heaven and earth.

Psalm 125:1
Those who trust in the Lord are like Mount Zion, who cannot be shaken but endures forever.

My brain is among the clouds

1. Was sick yesterday. Have been feeling tired and the urge to sleep alot too lately.
2. Was stressed over post-V&P interview, now have to decide whether to return the membership form on Wednesday.
3. MCR (ie monthly practical exam) went on longer than expected as there were 2 students doing it today (examiner was busy last week due to AMC visit.. but the case we were assigned was GIT / abdomen. How do you find an abdominal case in an outpatient clinic of which majority of patients come in with hypertension . diabetes?)
4. As a result of the MCR, I was unable to attend bedside teaching today. Our surgical bedside tutor was damn pissed coz as a result of some miscommunication, other group members didn't clerk patients beforehand 2 be presented. As a result, all had to bear the brunt of various not so nice words coming out from him lar.. "atrocious, unprofessional, worse than the group before this, horrible, lazy, not seeing enough patients, how are you going to become good clinicians, disappointing, last time we all camp out in the wards to look for cases and now u guys would rather sleep instead of showing up for ward rounds etc" And needless to say, there was a lot of explaning to do lar, since he also walked from the wards all the way up to the clinical school to hammer the faculty staff..

Overall, a lousy day for me.

Addendum: Thank you to someone (you know who you are) for cheering me up with this:
Ah Beng was asked to make a sentence using 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. Not only did he do it 1 to 10, he did it again from 10 back to 1. This is what he came up with...

1 day I go 2 climb a 3 outside a house to peep. But the couple saw me, so I panic and 4 down. The man rushed out and wanted to 5 with me. I ran until I fell 6 and threw up. So I go into 7-eleven and grabbed some 8 to throw at him. Then I took a 9 and try to stab at him. 10 God he run away.

10 I put the 9 back and pay for the 8 and left 7-eleven. Next day I called my boss and told him I was 6. He said 5, tomorrow also no need to come back 4 work. He also asked me to go climb a 3 and jump down. I don't understand. I am so nice 2 him but I don't know what he 1.

Random holiday blues

1. I do not recommend taking the express bus from JB to Kuantan via the winding, uneven Mersing coastal road, especially if the driver thinks he is Kimi Raikonnen on a wet day.

2. I hate doing redundant work during holidays. (people I know will know that I mean)

3. I want a new car.

4. It's disheartening to realise that in the midst of my busy-ness, I kind of lost touch with a lot of people from my yesteryears, not to mention missed birthdays and forgotten faces as well..

5. I think I prefer to do work and remain in denial during the semester, than spend my holidays revisiting certain headaches that just won't go away.

6. After 1 semester, I just can't help but have the tendency to ponder whether during our 1st 6 months here, have we truly made a difference..

7. But I left JB last Sunday with a sense of hope that certain things which start small will bear fruit at the end of the year.

The usual end of semester clinical skills log book + assignment rush

Of old people and venepunctures..

The thing with knowing a little bit more Mandarin (now that I'm in JB), is that you know what patients say about you (especially when it comes to criticism).

Went for blood taking today (coz of the mad dash to fill up the log books for physical exam and procedural skills before end of semester.), and did quite ok lar (for someone whose last venepuncture was 4 months ago), success rate of around 60%, (minus thom I pass to the staff nurse because their veins were hard to find).

There were 2 stations in the procedure room, and patients were lining up beside the tables lar.. 2 funny things happened lar:
1. While pricking the finger of a lady for glucometer testing, she jumped up of the chair. That was how sensitive she was to pain.
2. Second lady whom I pricked for glucometer asked me why am I shivering when I held her hand.

Then there was this Chinese lady who brought her mother for blood-taking. As me and a few of my group mates were practising, the lady (cradling a child), was standing at the door, complaining / nagging "Ni kan, chuen pu shi shue de leh.. chuen pu san ge shi shue de leh.." (ie Aiyoh, you see.. all 3 of them are students leh, students learning how to do stuff).. She repeated that same phrase at least 5-6 times that even while taking blood from other patients, that I felt annoyed having to listen to such distractions (we know who we are, so shut up and let us do our work lar). Then her mum's turn came and she sat beside me lar. Her mum asked me, "You doctor ar?" The staff nurse clarified to her that I'm a medical student doing my practical in blood taking. Her 1st reaction was to jump out of her seat and say, "Har??? Pelajar saya tak mau, saya mau missy cucuk" (Huh, I don't want students to poke me? I want the nurse to do it!). The nurse persuaded her that if she doesn't let us learn, how are we going to become competent doctors in the future.

I mean, fine lar.. if she doesn't want me to do, I can proceed with other patients, it is her right to refuse. What did she end up doing instead? On the spot, she went on ranting and grumbling in Mandarin on 101 reasons why she doesn't want students to do procedures on her (eg students don't know how to do procedures lar, painful lar etc etc). Even when I was changing into a new pair of gloves since there was blood on the old one (but I wasn't in a hurry to do so) she remarked that I don't know how to put on a glove properly - in plain sight of everybody lining up. *sweat*

And you have patients who tell you bluntly in the face, "Sorry ya, I want the nurse to take my blood, I don't want to become your guinea pig today."

Anyway, on a lighter note, bumped into a fellow church member from family group, who was visiting her father in Ward D for cancer and TB I think. Found it amusing for her young son to call me 'kor kor'.. (eh, at least he doesn't call me 'Uncle')

Today at the clinic, we saw a female Indian hypertensive patient. She had her whole uterus and ovaries removed, and apparently was rather depressed lar coz her husband divorced her after she could no longer fulfil his sex drive. Found out that she was a towkay (boss), maybe doing business. I was walking back and almost reaching home when she pulled over and offered me a ride, in her Mercedes E320! (quite some time already lar the model, but still..!! I kindly turned it down lar though, since I'm arriving at the front gate of my apartment already :p lolz).

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.

Just one of those bad weeks

Medicine; a profession that combines scientific knowledge, the art of compassion and skill. The hands of an expert surgeon deftly cuts the skin and sutures the wound with such precision that if you take away the surgeon's arms, it is as if he becomes nothing short of being useless. Control. Something which the most skilful of doctors possess. Ever wondered what is it like to lose it?

But before that, it has been an emotionally and physically tiring week for me. Monday: I was coming off some headaches about a few things back home.. then I interpreted a few things which my shepherd said the wrong way.. turned out to be a bit of a misunderstanding lar, which I was stressed about. As much as I try to not put God into a box, I end up doing so at times. And it does get frustrating, the stress just piles up.

I have been sick since Saturday (your usual cold, fever and headaches), probably thanks to sleeping 20 hours in 4 days in the past week. So yeah. And Monday night I was SO tired, but had to cram something right for MCR? Tried studying CVS and respi from Talley the night before until I just knocked myself out to sleep around 11pm. Then, woke up at Tuesday morning 6am feeling guilty that I haven't studied enough, cram the remaining systems (GIT, haemato, MSK, neuro, endocrine etc) from Talley's clinical examination + Oxford Handbook of Clinical Medicine (since you need to give investigations and management of conditions also) until my brain just cannot take it anymore at 12 pm. Tuesday turns out to be a nightmare. The dreaded phone call came at 2pm, when my examiner called me to the wards to interview a patient. And for all that I read up, I got a patient with asthma. The worst part was, I bungled it up, missing bits and pieces of the history, and was so tensed up (was also trying to do away with note-taking, since it was banned by my tutor) that I kind of messed up my presentation, and also totally forgot about the investigations and management of asthma. So obviously failed lar. My examiner even remarked, "Didn't I take you guys for your 1st PBL on asthma?" Ouch..

Feel dumb lar at times honestly :p, coz I haven't really been studying also. Even if I do, wouldn't remember when being questioned.

Went back home, was super emo that I didn't really felt like talking to anybody lar (I think if anybody came and disturb me I would have slapped him lor :p), so I downed a large set of pizza to vent my disappointment (hey, I had never failed before ok. 1st time). Then, something happened that night. I don't want to mention here lar what it was, but in short, with the mood I was in, it made me felt rather -duno what suitable word to use, my brain was like a blender- lar.. like, "I can't take this anymore. Too much.. I just needed to go away. Alone." But to cut it short, it turned out fine lar in the end. *goes to a little corner, looks up, and thank God*

Went back home it was already 2am in the morning.. Couldn't sleep, and when I finally did, the toilet bowl valve gave way, and the sound of gushing water woke me up at 5am. Ridiculous. I was already lacking sleep like a zombie.

Ben was kind of right lar I guess. I had a bad day. Or a bad week I suppose. We all do. At times, I get stressed up at things which I shouldn't be.

I managed to reschedule my MCR with my tutor before she flies off to Australia. Deadline is 9 May, she will only be back on 7 May, so a bit rush. And of all days, she had to put it on a Friday, meaning I only had 1-2 days to prepare. So stressed lar..Didn't really felt like studying lor.. Just go in only lar, surrender it all to Him. The night before I was feeling sick (again!).

But as I did my MCR on Friday, there's just this throbbing headache which I could not explain. Maybe I'm just too nervous and stressed. 'Good luck's' and 'All the best's' don't seem to be working. Was walking up and down the corridor of Monash. Hillsong MP3 + Pray pray pray.. Just needed some time alone again lar.. Then I went to the wards 30 minutes early for nothing. I look at my tutor, she looked at me. "Stressed wei," I remarked, and we laughed. But I guess when the moment finally came, I was just amazed at how smoothly things went.. it was a more complicated case than asthma previously, but I was getting more bombarded questions correct than the previous one. The best part is, the case was rated 'Medium' complexity (compared to 'Low' for asthma), and I nailed the diagnosis: Congestive Cardiac Failure secondary to ischaemic heart disease! (Note: I checked the patient's case notes the next day) YES! *pumps fist into the air* So happy.. no doubt lar the marks were not as high as I would have loved it to be (ie cukup makan pass), but I'm contented, considering the fact that it was a very strict examiner.. I passed my 1st MCR!

On Friday I got into a little bit of dilemma, basically between doing the popular thing to help some people (which everybody is happy to benefit along, but if discovered, the consequences may be severe) and doing the right thing (unpopular decision which will most likely end up not helping anybody, but my conscience is clear). I chose the latter lar, and yes, I think although we did not get what we wanted, I feel glad about it.

I learnt it the very hard and painful way on Saturday, during church choir, something along the lines of Mary and Martha. On how you can't always get things / circumstances clearly blocked out the way you wanted it. Voices and formation were not even close to perfect. People came late. 2-hour practice ruined your plans when it dragged on from lunch til dinner time. Extra weekday practice sessions came in unexpectedly (I'll admit: I'm a control freak. Medical student, what to do?) But being simple yet focused people, they enjoyed it. They seemed happy in the midst of it all. A simple heart and mind. Something which used to annoy me. Something not very easy for me to do.

I was glad that Sarah (former IMU CF friend, currently in Sydney was sharing, "Sometimes the thing with control is the need to learn to let go, coz you won't know what is going to happen to your patient; whether they are going to die or live." I guess letting go doesn't mean simply throwing things away / giving up on the circumstance. It just means believing that you have done your best, and all things will work out for the good of those who love Him, be it your patient, or other stuff.

Overall, a tiring week. But His grace is sufficient for me.

There is this patient in my ward with muscular dystrophy (forgot already whether it's Becker's or Duchenne's), but he is a young man, in his late 20's / early 30's. he has been confined to bed, and basically what happened was his respiratory muscles are wasted that he finds it hard to breathe. And he was admitted due to a chest infection. It's a terminal familial disorder, 4 of his uncles died of the same disease, and he looks to be headed in the same direction (bad prognosis). His eyesight also seems to be failing. Yet, he still smiles at us during our bedside.

There are times, while interviewing supposedly sick people (some of which might be dying), I just can't help but wonder what keeps them smiling / so willing to cooperate. Acceptance? Something they cling on to? Hope for the better? Or is there something they see in us?

I'm supposed to bake tonight..

..but I don't feel in the mood to make brownies. I was emo, so I went and printed out 18 pages of journal articles which I probably wouldn't read at all.

I think I shall read up more next time before I walk into a PBL.

Today I was supposed to clerk and examine a patient for tomorrow's bedside teaching. Last week a patient thought I was Japanese. Today, the patient thought I was Pakistani (what the??). And being a diabetic who had a below knee amputation of his right leg, he clearly was not happy with the doctor for not saving his leg, coz he heard that some. His daughter, who is a pharmacist understood that the doctor back then would have explained the need for the procedure. But he started rambling about irrelevant stuff which I don't really wanted or needed to hear, analogies like how doctors are more concerned with buying a new car (ie amputation) rather than repairing the old one (conservative treatment). So I wasted 20 minutes entertaining him, and missed witnessing a lumbar puncture, coz a bit not nice lar if you leave all of a sudden, his family is there.

And I guess I just have quite a bit of questions runing through my mind at the moment..

Post-mamak mumblings past midnight

Me, Ben, Chris and Anna tried studying at the mamak beside our apartment. IMHO, didn't work out very well for me (unless you can see Ben enthusiastically doing his homework). It's ok, we'll probably try the Hyatt hotel tea house next time (apparently the cakes are quite nice). Ben quoted that too bad there's no Starbucks nearby.

I guess some things are best left unsaid, but rather penned down and chucked away somewhere far away, where you'll probably never see it ever again until you decide to reflect upon it sometime in the future.. Aren't they? (no, I'm not referring to the 'H' or 'D' words.. ) as in; some things which you already know the answer, and there is no need to talk much over them, but you still choose to blurt them out - and its effect has evaporated upon repetition. not sure why.. or maybe even other matters which technically have already been resolved, but brought back to the surface. Duno lar..

I'm tired, and sleepy, and I didn't really prepare much for the PBL tutorial tomorrow (I will admit that I hate walking into PBLs not knowing what in the world I'm talking about - at times it gives me a sense of insecurity) I had a fall yesterday and bruised my left knee (ie now I'm limping in a crepe bandage for 3 days). I have trouble walking up and down the stairs, as well as getting into a car (Why in the world is Monash located at the top of a hill?). And I'm supposed to somehow make my way to the wards to find 3 patients by tomorrow, and also finish reading basic ECG? You kidding me?

I'm thankful I'm not doing surgery posting 1st. Although it's less taxing in terms of exam material, apparently surgeons (especially Malaysian surgeons are crazy). They call you in the middle of your dinner at 7.30 pm, or while you were sleeping at 5.30 am, and tell you, "You have 15 minutes to gather everyone in your group and come to my Operating Theatre / Clinic, I want to show / teach you something." and if 1 team member cannot make it, apparently it is an insult to them, and the whole group can forget it.

It's only the 3rd week.. there's already silent ramblings on not wanting to repeat 3rd year. Stress levels are up. And here I am, sitting here, looking up and wondering. Just..wondering. Wondering what can be done and what will You do.. And sometimes even zoning out.

On a different note, was wondering how does one practise 'The Celebration Principle'? ie John Maxwell - 'The true test of relationships is not only how loyal we are when our friends fail, but how thrilled we are when they succeed.'

Post holiday blues

Spent Saturday at City Square (kind of like a smaller version of KL's shopping complexes). Ended up going on an 'emo' shopping spree, spent more than RM200 on story books and autobiographies. Then, went and nearly drown myself in the swimming pool (I can't swim. Problem is; That did not go down well with me, so I insisted on forcing myself to learn.. still learning)

Last night, I slept late coz i had to do the roster for my group members. Super hard to squeeze people in different weekly slots to avoid overlapping of tasks. Did not really have time to read up for today's ward rounds, so was feeling rather stressed about it that I could not really sleep (although it's already 1am). Woke up at 7am feeling tired, sleepy, sick (on the 1st day of clinical years), and cranky, as if I'm the most miserable person on the face of the Earth. Was expecting to be roasted in the medical wards (by the super fierce head of department, whose reputation precedes her, if we ever bump into her lar) and tutorials (since I did not read up anything).. turned out to be better than expected though.. we got a very good Pakistani doctor who really knew his stuff, and managed to explain everything in detail. Physical examination; not the best, could use more practice.. we were looking for a patient with COPD, and turned out to be a Chinese patient. I was like thinking, "Aiyoh, I have to speak Mandarin with this fella??" Fortunately the guy was from Perak, and was able to speak Cantonese, but mine is still abit broken here and there lar.. And we had a good laugh during the clinical skills tutorial. Tired, but I think it's an ok start..

And it finally rained in JB after more than a week or so. Nice weather to sleep..

To start off the New Year

Ever tumbled unexpectedly into a valley, made it through bruised and battered, with many lessons learnt, greeted by a beautiful sight, only to realise that the only thing lying in the way up ahead is a tall, rocky mountain shrouded in the mist?

1. I just studied thyroid and peptic ulcer drugs a few days ago. I did the formative quiz on MUSO and got the answers wrong. Was reading on MUSO how the Aussies' debate and discussions on certain topics show their depth of understanding of the topics they have studied. Felt like an idiot.

2. 3 days to 2nd year exam on Monday, and I have only finished 25% of 2nd year's work. And on Wednesday I have a 1st year + 2nd year combined paper. Haven't read much for that. And I'm super sick and fed up dy of staring at books from 10am til midnight non-stop. Mental block and can no longer absorb anymore.. Fever. Headache. Agitated..

While Clayton had all the time in the world to study from books and grasp certain concepts, here we are trying desperately to memorise as much bits and pieces of lecture notes as possible to be able to regurgitate them out in time for the exams.

All I know is that I don't want to sit for supplementary exams in December (ie I DESPERATELY want 2 pass.. 4get the results, at this point I will be happy if they don't phone me by 30 November).

....

Why in the world am I even bothering 2 rant it here.. Go away.

OSCE blunders - duno whether 2 laugh or cry

Slept at 1am, woke up at 5.30 am staring at the ceiling, stoning.. duno what 2 do.. tried 2 sleep back, but then it was freezing 4 some unknown reason..

Ok lar.. this is it so I thought, since we did not have much time 2 practice due 2 work overload, juz go in and c how..

Station 4 - Urinary system. Look at the patient and wondered how come so familiar wan? Then when patient looked up, turned out 2 b Shu Yi.. Didnt know how to proceed with the history coz patient was in super alot of pain.. only managed 2 reach family history..

Station 8 - Haematology station, explaining blood test results to patient (iron deficiency anaemia):
Patient: Ok, so what is this ferritin and iron saturation ar?
Me: Erm..
*stoning.. why does 8 minutes take so long to pass by - ended up simply crapping sumthing*
Patient: So what do you suggest I do ar coz I've been feeling very tired leh..
Me: Erm.. take iron tablets?
Patient: but i live in rural area leh.. my family is poor and husband busy, I have to look after the 3 kids..
Me: Erm.. do u take red meat (ie beef)?
Patient: No. Expensive..
Me: Erm, mayb u can try green leafy vegetables?? got non-heme iron kua..
Patient: *blank look on the face*
*sweat*

Station 10 - Cranial nerves of the eye
Me: Hmm.. looks like easy station..
*walks in, looks at simulated patient*
CHUA LI WEN!! WHAT IN THE WORLD ARE YOU DOING HERE??
*heart stopped 4 a moment and immediately suffered mental block - somehow bitemporal hemianopia became bilateral hemianopia and the medial retina fibres which cross at the optic chiasm became temporal fibres.. pfft*
Note: Now u know y doctors r discouraged from treating their own relatives or friends, as it may affect their objectivity.

Station 11 - Respiratory station:
Me (running out the door after the station): Wait, what is this around my neck? This does not look like mine.
Examiner: Ya, come back with my stethoscope!!

Throbbing headache after OSCE.. went back home 2 sleep but couldn't. ended up stoning in bed, staring at the ceiling 4 more than an hour..

Stuck in a moment

.. actually, kinda more like lost in transition..

duno lar.. feeling emo, suffering from cold, fever, insomnia and stomach upsets.. probably the effects of studying til 3am and waking up at 8am.. super unprepared 4 the exams..

I dun like transition phases.. as in having to move on after a short period of time.. in 2 months time it's goodbye undergrad campus life, hello hospital phase in JB..

It's like 1 year i was in Aussie, then 1 year here in Sunway has been so stressed and zoomed past so FAST that I just did not even have the time to sit down and ponder or reflect.. yes, i am thankful for many things this year.. but didn't like that feeling of having 2 uproot so fast, not knowing what 2 expect for the next 3 years..

It's just.. me, and my difficulty accepting the need 2 move on from point A to point B.. I'm thinking too much, maybe I should go and re-read the SPM novel Terminal Tiga :p

Faculty lockdown

6 days countdown 2 da OSCE (ie practical) on 7 November.

We had our first discussion today and a bit of practice based on the questions they released for us to prepare, hoping 2 continue our tomorrow and next week. Look at the questions also felt like dying dy, some of them look like history taking stations, but you just cannot guess what nonsense they are going 2 throw at you. Example:
Part A
Discuss contraception with Mrs X, answer her questions appropriately.
Part B will be given 2 u after u finish Part A.

No big deal wat, we thought, since from 2-8 November they will only seal off the learning suites and we should be able to still use the Histopathology lab to study, practice and print stuff.. at least that's wat we thought..

Today, apparently, they said during the 1 week period, access to admin staff and ALL LEARNING FACILITIES will be off limits to students. They want to use the histopatho lab for quarantine, so it will be locked up (cannot even come to study) and to prevent leakage of questions, they will be cutting off the internet access too??!! No borrowing of medical equipment for practice will be allowed after today.

WTH??? even da library will be super packed with other students studying..

and 15 lecture notes are missing (ie not given) on the repro system - considering the fact that it makes up 25% of our exam on the 12 November. Currently chasing the lecturers 4 them..

Crap, super S-C-R-E-W-E-D...

Addendum: In an about turn, the faculty decided now that the histo lab will be opened on weekends and Tuesday. yay!

Not something I need at this point of time

Can someone enlighten me how am i going to finish studying all these in 2 weeks?


Screw ups.. the overload of assignments this semester, and as I came home late at midnight yesterday, hoping 4 a nice quick shower and then hitting the books, power at the condo went out. That was just the beginning, as cockoraches started coming out from the exposed ceiling tile - not one, two or ten, but the entire colony!!! Cockroach wars! By the time power got restored around 2 am, the toilet looks like a nuclear warzone after we emptied 2 canisters of insecticide.. I counted around 150? crap, how 2 study???!!!

The mad dash towards portfolio submission

Monday, supposed to submit a collection of assignments worth 30% of the whole year's marks..

8.15 am - Woke up and realised that I was late for assignment meeting.. crap.. could nto really do much at home coz hostel internet broke down..
8.30 am - God, why is it raining so heavily??
8.40 am - Rained receded a bit, walked under the rain.. luckily on the way Sue Wern saw me and gave me a lift to uni..
9.00 am - Went and top up print quota RM 20

..and later spent duno how long printing endless pages of reflective essays and HLSD interviews.. sent the edited version of the 3000 word Health Promotion report to our academic advisor for proof-reading.. He said it was ok, only got a few things to edit. Then, found out that we were SO over the word limit with 3800+ words.. need to chop.. opened the file, and I was wondering, "I thought yesterday I spent the whole day editing the sections b4 sending it off 4 my group member 2 do referencing, HOW COME THE SECTIONS LOOKED DIFFERENT??!!" No time 2 really bother dy lar.. spent the entire lunchtime adding appendices and editing til 3 sumthin.. printed my additional pieces of work earlier (man, colour printing already burnt a big hole in my pocket.. RM7.50 for 5 pages in the additional pieces of work..

Then, they dropped the bombshell.. we printed double copies of the HLSD interviews already, now they tell us they wanted a photocopy of the consent forms as well.. so went 2 office to submit other assignments first 2 clear some stuff out of the way, they turn me away and ask me get everything done then only submit at one go.. felt like blowing up on the spot.. so I ran to the bookstore 2 get stuff photocopied. stupid bookstore, u know rite at some shops if u photocopy more than a certain amount they give u somethin like 5 cents per page.. Here dun have, RM9.20 (10 cents per page), super expensive.. if not coz its raining and I was in a rush, I oso dowan 2 do it there..

Then another bad news, they wanted a second copy for the 2 additional pieces of work. *pengsanz* i'm not going 2 print out another set of coloured slides.. total waste of money. so i went 2 photocopy, that guy said sorry come back in 10 minutes, he needs to go to the toilet.. WHAT THE..

There was a LONG queue after 10 minutes, so there I was waiting.. super cannot stand dy.. dun care lar.. for additional pieces of work, just grab CF posters which happened 2 b on the wall 2 supplement my reflective essay (convenient :p)

4.55 pm - Submitted assignments just in time.. there was a super long queue at the office, and those who ended up submitting after 5pm although they were waiting there for ages apparently will be penalised 5% of their marks.. what nonsense.. with last minute notices that we will have to make double copy for everything, now they say its our fault?? Hello? I'm supposed 2 b practising my OSCE practical exam leh b4 tomorrow's mock exam..

I'm tired, cranky, sick (headache, cold, fever and whole body aching) thanks to 4 hours of sleep per day for the past week rushing this project. Apart from a Mars bar for snack, I did not eat 4 whole day til dinner.. Last but not least, I'm FED UP with all the nonsense they are putting us through..

but..

Guess I'm being taught to be thankful for little things that come my way.. postponement of the deadline (otherwise it would have been due last Friday and we would have all died miserably), a carpool in the rain, the fact that our academic advisor said our HP essay is ok, how fortunate it was that I managed to submit b4 the office closed the deadline and started penalising people..all happened by God's grace.. Guess I'm not being appreciative or learning it that well though..

Oceans will part (the same goes for my studies and assignments?)

This year has promised so much and yielded so little in terms of what I expected. [sigh..] Frustrating, so many things has happened, that quite a lot of people I know are on the verge of burning out already. Me too.. I think I lost count of the number of times I broke down last week.

But for all that has happened, I am indeed thankful for the little pockets of encouragement that has come my way.. though my second (supposedly last) year as an undergraduate student on campus b4 going 2 JB 4 clinical years was ruined by the faculty.. H-E-L-P, I want to see this final killer week through despite 6 assignments due..

I will worry about my exams (less than a month away) later, since I have not started studying any of my 1st and 2nd year notes at all. When will all this madness end?

On the brink..

10-16 September 2007

Monday
Headache. Blame the perfectionism.. or better still, blame the pride.. I duno lar, probably it was the head massage the traditional medicine pracitioner gave me in Segamat (nearly detached my head from my neck! until I couldnt walk in a straight line), or the heat stroke I suffered playing football in the 2pm hot sun.. felt like fainting, and also my body inside was boiling.. the after effects of rural placement activities..

Overslept and couldnt make it 4 CF prayer meeting at 8am. Haven't really been sleeping well for the past week or so ever since coming back from Segamat.. Rushing the rural assignment.. imagine lar classes were from 8am til 5pm, and still rushing that stupid 2000+ word essay late into the night. Sleeping at 2-3 am plus.. it's just me being fussy lar.. editing every minute little nitty gritty part of the assignment to the extent that what can be done as a group in a day or 2, gave me 3 sleepless nights.. that also our paediatrics case wasn't really complete, a lot of stuff couldn't be obtained from patient interview (if its marked by our rural placement coordinator - who happens 2 b a paediatrician, can die wei..)..

Worship revival night at 8 pm, didn’t feel like going.. Go! I will go.. phoned 4 anyone who happened 2 have transport.. Helena replied that we are leaving at 6 pm.. *pengsanz* need 2 rush there after class.. but yeah, like Pastor Willie said, press in.. sing like you have never sung it b4, from the bottom of ur heart.. do not leave this place missing out on God's presence.

Tuesday
Imagine lar spending the whole morning editing and researching 4 the rural assignment and trying 2 prepare my task 4 anatomy practical later in the afternoon.. had 2 also get the worksheet done 4 the visit 2 the orang asli village..

Later in the afternoon, we had Associate Professor Tony Buzzard from Monash Clayton campus, Australia 2 give us a lecture on the Abdomen and Pelvis.. he was quite good, although almost all his powerpoint slides are just pictures from textbooks.. later when we are having the practical, he was walking around observing what we are doing.. When it came to my turn to present my tasks 2 my group members, he just sat there right in front of me and asked me 2 go ahead. (I was like thinking.. WHAT IN THE WORLD..??) Duno lar.. just pretend 2 act smart and present as if I know a lot (although there were some parts I duno what I'm talking also..) when I finished, he said "Good." and walked 2 the next table (duno lar what kind of impression I gave 2 him about Malaysian students)..
Later went home in the evening only 2 realise that I lost my green plastic document box (ie plastic file), with the past few weeks' important lecture notes and documents inside.. Crap.. couldn't sleep the whole night (head felt heavy).. super burnt out til wanna cry dy.

Wednesday
Community Based Practice placement.. kinda like the community service project mentioned in earlier blog posts.. one of the school teachers were not around, so my group had 2 take care of a class of students belonging to the most severe cases (of intellectual disability).. I tell u, these ppl will not sit down and do work when told.. absolutely total chaos, they were running around the class, banging the tables, some of them tried 2 whack me, things were falling off the cupboard thanks 2 them, no wonder the class teacher was yelling at the top of her voice.. *more headache* irritating kids.. felt like slapping them..

Afternoon - fellow CG member msg me, asked me whether I can be the chairperson for CG this week (F.R.I.E.N.D.S. and B.U.D.D.I.E.S.) we are now at D.D. of B.U.D.D.I.E.S. (Develop and Discuss).. the theme was basically good and bad characteristics.. i said ok..
Later at CF (welcoming reception - return of the meddies) - headache over who 2 help 4 the RM50 ministry project leh.. btw, CF dinner was at Bak Kut Teh of SS15 (Argh!! I miss bak kut teh. Crap, cannot go coz need 2 do work. Eh, why do u guys have 2 go there lar on that day)..

Felt rather miserable, headache coz of the assignments.. stayed back til late.. Tried 2 print some of the photos I took 4 my CBP project, but the instant photo machine at my hostel ate my camera's memory card. NO!!! Not at this time???!! Wah lau.. Now I can't take photos tomorrow. Stupid machine.. Returned home feeling tired, cranky and sleepy, roommate asked me 2 help him with referencing 4 his assignment.. felt like telling him off as to why in the world is he allowing himself 2 b forced 2 do science if he is more interested in graphic design.. eventually referred him 2 Monash library tutorial website 4 Harvard referencing. I cannot take this anymore.. Honestly, 95% of me did not feel at all like being chairperson for Thursday. Can somebody else replace me 4 Thursday?? I just do not want 2 care bout anything anymore..

Wait. I have a choice. I can stay on this way feeling like crap all week long, or I can choose 2 go the other way. I'm not going 2 let all these nonsense deter me. I will do this. I can do this.

Thursday
Slept at 1am (same heavy head which prevented me from falling asleep).. woke up super early coz 2day wanted 2 rush 2 the CBP placement site early 2 do gardening.. had 2 episodes of stomach discomfort and had 2 go 2 the toilet.. was starting 2 think "Great, what in the world is going 2 happen next?"..

Afternoon - shepherd called 2 ask whether everything's allright 4 2nite's chairing.. That reminds me.. how 2 go about chairing? No idea yet.. phoned my assistant CG leader 2 check what is she sharing and how 2 correlate with my part.. She msg; The title of 2day's sharing is 'Radiant certainty'. Huh? Excuse me? "Oh, its about faith. Try 2 bring in or share elements or quotes which talk about faith, without mentioning the word too much if possible."

*Pengsanz*

Contradictory 2 what I was told yesterday.. How in the world do you link good + bad characteristics with faith? and my PCL homework not yet finish leh..

7.00 pm - 30 minutes b4 CG starts. still looking 4 inspiration. 5 mintues b4 caregroup starts.. Something roughly came 2 mind I think, but what if the visitors who know me are coming? Embarassing lar if I duno what I'm saying and looked awkward.. aiya dun care lar.. try my best..

So ya, started off on a happy and joyful tone.. and later asked everybody 2 introduce themselves by sharing their name, course / work, a good and bad characteristic bout themselves, or actions which they have done..

Later, shared the following:

Romans 5:1-5

Therefore, since we have been justified through faith, we have peace through our Lord Jesus Christ, through whom we have gained access by faith into this grace in which we now stand. And we rejoice in the hope of the glory of God. Not only so, but we also rejoice in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not disappoint us,

"Just now I asked you guys 2 share bout good and bad things bout urself. If u had noticed, most ppl shared their bad thing first b4 the good things. In a job interview for example, if the interviewer asked 4 our strengths and weaknesses, we find it easier 2 list our weaknesses, than finding 4 1 strength. Most of the time, the reason for this is probably due 2 the lack of confidence in ourselves.(eg Why cheat in exams? Coz afraid of failing. Why get angry and scold people? Coz stressed, a lot of work 2 do..)

However, speaking bout confidence, take for example, if we are representing our country in the Olympics 100 metres, competing against the best (eg Tyson Gay, Asafa Powell etc), most people will probably be thinking 'Aiya, since u r goin 2 lose anyway, wasting time only lar..' But r we able 2 see beyond that finishing line - to have faith in what we can do and say, 'I am here 4 a reason, after all the hard work I have put in, I'm just going 2 give it my all and hope 4 a miracle from the God of endless possibilities (who is able to do more than we can even think or imagine) that even something good can come out of this.. Don’t care what people say bout me being useless, or even if I lose, at least I still did my best.’

For all u know, ur effort and actions might just somehow turn out 2 b a positive inspiration / encouragement 2 other people who will think 'Hey, there's something different about this guy that I really look up to in terms of his character. Despite his youth / inexperience / weakness, he has a strong self-belief and I want him 2 b my role model.' So just want 2 encourage everybody 2 continue 2 exercise faith in all things we do."

Yes.. that's probably something I need in large amounts too these days.. Most of the time, it's just so easy to see that huge mountain right in front of our eyes, without noticing who is behind that mountain..

Friday
Rural assignment handed up. I will be hoping 4 the best.
Got back my camera memory card from the person servicing the machine.
Checked my exam results. My second most unprepared exam ever, but this time I went back up 2 distinction (between 70-80 marks)! Ok lar.. maybe not much 2 brag about since its only 5% of the year and they removed some questions, but it’s still a form of encouragement 

Saturday
Campus bookstore person emailed me; my green file has been found. YES!!!

Sunday
After 3 weeks of disappointment and anxieties, finally managed 2 interview one of the kids in church 4 my Human Life Span Development (ie psychology) project. And I was lucky – she turned out 2 b a chatty one – after 20 minutes I don’t know what else to ask already and got stuck, she prolonged the conversation 4 another 10 minutes! Haha..

Eventful week 2 reflect on.. I could have chosen 2 not challenge myself 4 Thursday, and things might have been different then. But yes, God has been great. Behaviour change project due tomorrow (Monday), SPC presentation on Tuesday. Bring it on!

Updates (19 September 2007):
Behaviour change project submitted dy..
SPC presentation was fun and we finished it in style!

Let's see what's left and their deadlines:
Rural reflective essay (1500 words) - 1 October 2007
Reflective essay on group work (1000 words) - 2 October 2007
Community Based Practice Presentation - 18 October 2007
CBP Health Promotion Project Report (3000 words) - 19 October 2007
Human Life Span Development Interviews and Essay - 19 October 2007
2 additional pieces of work (ie painting, volunteering, committee member experience - basically 2 show that u have a life outside medical school) - 19 October 2007

Final Year Exam on 12 November, combined year 1 + 2 paper on 14 November. not to 4get da OSCE (ie practical)

Guess what.. haven't started studying yet.. need 2 start somehow..