Escapade to Sungai Lembing - small tin-mining village town

During the Raya holidays, me and a fellow ex-classmate decided to do something which I have not done before - conquer Bukit Panorama. In order to make it to the top of the hill to catch the sunrise, we departed for Sungai Lembing at 5.00am, a 40-minute drive from Kuantan (it was crazy, woke up at 4.30am during school holiday)..

Upon arrival, the small village town was quiet, but you already see coffeeshops selling breakfast open for business. It was pitch-black, you actually need a torchlight to ascend the hillsteps. It was an alternating trail of concrete steps and slippery slopes, as some parts of the steps have been washed away by rainwater and landslides, so it's pretty hazardous to come on a rainy day.

A fellow friend asked if I could actually make it to the top (since I don't frequently exercise :p), but if I could conquer 1000 steps in Kokoda, why not a 400-metre high hill? So I finally made it, and so too did many other people, but to our disappointment, the view of the sunrise was partially obstructed by clouds in the horizon.. oh well, might as well take a few photos. You can also see a bit of the morning fog in the valleys below.

After breakfast, since the old tin mines were sealed off due to collapse, we went over the hanging bridge to a small housing area. Here, one of the industries include making noodles which are somewhat used for 'wantan mee'.. then we ended the day at the local museum..

To check out more photos, click here.

Alpha course weekend away

Went down to KL to catch up with ex-CG friends from Hope KL. It so happened that SSC unit had a trip to a small village town of Broga in conjunction with their Alpha course, which I tagged along. We started off at 7am, and arrived at our destination around 9am for breakfast. It was then a time of exploring the OUTBAC compound, with fun outdoor activities such as kayaking, cycling, obstacle courses integrated along with teaching sessions on the topic of the Holy Spirit. Challenged myself to take on some of the activities, with mixed consequences..

It was a refreshing time to see new people in the Subang-Sunway group, and also an opportunity for me to refresh myself on the topic which I have not read up for a while, and might need to do some teaching on soon. I think it was great that as a group, we are able to honestly express our burdens / issues and pray for one another in the afternoon.

Night wrap-up with the campfire in the background was awesome, as each person shared what they learnt throughout the day; a new perspective on the topic being taught, a refreshing time of fellowship and team-building - helping one another overcome the obstacles. I don't really join them much nowadays, but as someone who is graduating soon, I could only remind everyone to treasure their time as a group while they are still students, to support and encourage each other, to grow in service, practise what they have learnt, and make a difference wherever they are.

And we shall cap things off with a song - with of course some accompanied background music :) Check out the rest of the photo album here.

As it rains..

A pretty wet week to end my emergency department rotation.

I learnt that in emergency medicine, you cannot forget your anatomy and physiology.

Chinese patients can be difficult to please. Was asked to look for the patient card for a patient, and my mispronunciation of the patient's name earned me a sarcastic jeer from his wife, "You are Chinese, but don't know how to pronounce people's name properly.."

1 elderly patient with bladder cancer was brought in for body weakness, diagnosed with urinary tract infection. He was supposed to have an appointment with the oncologist at Hospital B*, but the wife thought that he was wrongly sent to Hospital A* where I am posted. The patient was discharged with antibiotics, and the initial plan was for him and his wife to go to Hospital B by taxi, but he complained of being weak and in too much pain to walk. The MO told her directly that there is nothing left for them to do, and despite repeated pleas, they cannot afford to use the hospital's limited number of ambulances to transfer the patient to Hospital B. The option of hiring a private ambulance service was deemed not worth the cost. Eventually, when nobody was looking, I took her aside and explained nicely to her that there is nothing we can do, since it is a policy set in place, clearly delineated.. She promised not to tell the doctors that I lent her my handphone to call her relatives to come and transfer her husband (I know I'm not supposed to, but it's something off the record as I see the need - of course I won't do it to everybody). I think she felt touched lor, as she replied in Cantonese "Thank you ar doctor, you are really a kind person." I think it's a sad case, as she can be heard cursing over the phone of how increasingly cruel and heartless the doctors in government hospitals are becoming, all simply because of a lack of empathy as people are just interested in getting their jobs done.

A baby was discharged from the neonatal ward with a poor prognosis of anencephaly (or some brain problem lar). The next morning, the parents awoke to find their child not responsive, and was most probably no more. They made a police report, and by right the police were supposed to arrange for a post-mortem and some kind of burial permit at the mortuary. It was not done. Before coming to the emergency department, the father brought the dead baby to the ward, going berserk when nobody bothered to explain to him what to do. When it was finally settled, I think it's ridiculous and disrespectful to observe undertakers from some casket company harassing and negotiating the cost of burial from the parents, trying to earn a living at a time when people are in grief.

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.

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!!!

Rural reminiscence

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








The summary of what we went through..


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


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

Kuching sightings uncensored

Was buying some tuak (Sarawak rice wine), when spotted this - of all the brands to give your alcohol drink :p

I think it has become a habit of me that I just couldn't resist doing something stupid everywhere I go (anyway who cares, not many people from Kuching knows me right? :p), so after we finished eating Sarawak 'kolo mee' at one of da stalls, I collected everybody's bowls, stacked them up for this pose :p

And the best part? This old couple was sitting beside our table. Watching their reaction (*stared at us, sweat and jaw dropped*): PRICELESS lolz (think they lost their appetite later and the uncle went on to spill his coffee..)

More convention photos coming up..

Rural Placement: Sightings in Segamat - Close Encounters of the Weird Kind :p