The 5 min Scrub - short takes in the life of a medical intern and other things not related

many things going through my head...

2011-11-11T01:40:00.000-08:00

in the past, I felt that personal things should be kept to oneself, not talked about. no matter how much they troubled you. work, relationships, friends..... im blabbering, but what does it matter, no one reads this blog anyway. its just another outlet for me...

Im seeing someone now. her name is Laura. she's great. I use to dread relationships....boyfriend and girlfriend, losing the freedom you have as a single person....relationship averse....and then I met Laura. you don't miss singlehood when you've met someone you truly cared about. there's so much more to do and see in places you've been before by yourself. It's like travelling alone, I've done that before. Being carefree, being whoever you wanted to be; but then as you travel you realize there is actually alot more you could do and see if you had a travelling buddy, be it a friend or someone special. I use to look forward to weekends, coz it simply meant that I did not have to work. but things got old, and weekends were often wasted just being by myself and not making full use of it to experience things around you....and then I met Laura. I can't wait to see her again even if I just said goodbye that same morning. I can't wait to hear her voice, even when I've just put down the phone...you become someone you don't expect yourself to be, you do things you would not normally do. you put yourself in a position that makes you uncomfortable just so the person you care about is happy...........................

palliative medicine has been quite confronting in all honesty. before I worked here, it seemed to me that the whole concept was the anti-thesis of medicine. In medicine, we help people get better, fight disease...make people better....but palliation was giving up, surrendering to the affliction. It was ok at first, then everyday someone dies......its not the dying that is difficult. They are comfortable and painfree... i hope. we try to achieve that. it is the experience of people coming into hospital, getting admitted.... knowing that they have come to die.......what exactly goes thorough a person's mind when they acknowledge the fact that they were GOING TO DIE. In a medical ward, you might still have the 'reassurance' that doctors will do all it takes to make you better. But in a palliative care ward, there would be no more treatment. There would be no more fight. What exactly goes through a person's mind when they wake up every morning, knowing that the next day is going to be an agonizing wait....and that if they wake up the next day they won't be feeling better, but will be feeling worse.

When a patient of mine's condition seemed to have plateaued and did not look like he was immintely at death's door, we had to find a place for him to go to. A nursing home. he said to me,' so the time has come eh? ' I had no idea how to respond, how do you even respond to something like that.knowing the time is coming, but you just have no idea when that was going to be.....

palliative care is sad. kudos to the wonderful nurses and doctors who choose to work in this field. working in a place where everyone is dying or waiting to die is tough, I have alot to learn.....

disappointed.

2011-07-31T05:13:00.000-07:00

today I set myself up for disappointment. thus, this will never happen again.

lost in the cracks

2011-06-27T06:34:00.001-07:00

so... early last week whilst I was going about my daily routine trying to finish up with ward work for the morning, I get a call from the radiology registrar. " Hi, I need to see if you still want this CT-scan to go ahead because Mrs XXX's renal function is deteriorating" "Mrs Who??" "Mrs XXX, she was here 3 months ago...." "......er....I have no idea who she is.." " well, ask your registrar, it has her name on the request slip, thanks *click*

me to registrar,' erm, I got a call earlier about some lady needing a Ct-scan, but has deteriorating renal function, do you still want it to happen?" " well, shes got pancreatic cancer, she is 87, she definitely needs someone to be following this up, th escan dosent have to happen urgently, but it needs to happen"

a few phone calls later and another few visits to the radiology registrar, I have yet to make sure this woman's cancer is beign watched. Radiology refuses to schedule a scan until they have evidence that the lady is fit to have it, patients GP is 'part-time' and therefore will not be at the clinic often enough to constantly monitor the renal function and book a repeat scan. Also, patient is NOT IN HOSPITAL.

This situation has bugged me for quite a bit mainly because of individuals refusing to take ownership of a patient who has clearly been seen by them, and NOT ME. Radiology throws at me stupid excuses of rare reactions to contrast if someone's renal function is not up to scratch, GP gives me excuses about the part-time employment. Why can't the stupid radiology registrar just book a date, so that at least some sort of follow-up is in place. Why can't the GP who is in the community just add a reminder to one of her GP programs that is so sophisticated these days?? why am I loking after someone, I have no clue about, let alone not a patient of the HOSPITAL?????

Here I am, in the middle, having to ensure that this lady's cancer is not left to fall through the cracks. She's 87, probably not fit for surgery, and my registrar reckons she might do with radiotherapy?? even non-invasive, it it not without its side effects as we all know.

this is ridiculous. a woman with cancer, and no one seems to care, just because she's not sitting in front of them. I wonder, how many patients are unfortunate enough to fall through the cracks like this woman?? How many individuals have missed out on early diagnosis or intervention, because someone far away decides that a scan needs to be cancelled, and then left up to some one else, in this case me, who has no familiarity whatsoever with this person to make sure things are in order. Am I handling this because it is my responsibility as a doctor with a duty of care to this patient who's notes happen to fall into my lap OR am I handling it because I am a fellow human being?? if so, why are the others shifting responsibility?? am I trying to do the same or convince myself that I am not by putting my thoughts into words to seek clarity...I do not know.

Internship!!

2011-01-29T16:46:00.000-08:00

Jan 12th 2011 was the day I commenced my internship. The day of being a doctor had finally arrived, after 5 years of ups and downs in medial school, the day that all us medicos look forward to from day 1 of medical school with excitement as well as trepidation. The first day of the rest of our careers had just started; real responsibilities and real consequences can happen with our actions and omissions.

It's been 2 weeks since I started, but I have only just been able to find time to pen my thoughts down. So I start of 2011 and internship in the town of Mildura, 8 hours northwest of Melbourne by car or a 1 hour flight. Mildura is closer to Adelaide then it is to Melbourne. Twas' a long and quiet drive up, uneventful, but rather enjoyable. This was also during the floods and I was lucky to have driven off from and through Echuca, abotu 1.5 hours before it flooded through. When I was going through, the Campaspe river was already looking to overspill the banks and onto the roads. Thank god!

Internship for me has started with General Medicine and the Mildura Base Hospital. A small and cosy rural hospital sufficient to meet genereal medical and surgical needs. The last 2 weeks has been busy. I did my first cover shift as well as my first weekend. working in medicine has been pretty good so far. lots to learn about medicine, dealing with patients and also equally as importantly, dealing with annoying nursing and pharmacy staff.

Cover shift

Cover shift is worst when yoru fellow colleagues are not organized and do not prepare the paperwork necessary for admitting or discharging patients. sometimes the patients come through, lying there in a bed and none of the medical staff seem to be aware that they are suppose to be there. Also, looking after and making decisions for patients that I had no idea of, from their demographics to their actual medical/surgical condition , this was sickening as it takes up a lot of time going thru the files and charts just to get a vague idea of what is happening and I need to do for the patient. Also, you have the nursing staff and pharmacists hounding you for discharge papers, scripts.............. and there is only 1 of me working.

Hospital Staff

So far, most of the hospital staff that I have met and had dealings with have been very approachable and helpful. The registrars have been great, welcoming us and supporting us in our daily dealings with patients and other staff. The consultants have been more then welcoming in inviting us to the team and making us feel comfortable on the job. However, needless to say there are always the annoying ones who try to pretend to 'advocate for the patient' but in actual fact are hindering the recovery of patients. And then there are the others that try to get you to cover up for their mistakes, re-writing scripts because they have given the wrong dose or sometimes even the wrong medications. They politely ask you to write up medications to help settle patients 'IF they get too agitated in the night' but the medication is more for themselves so they won't have a busy night. stupid irresponsible nursing staff, making us irresponsible just so they can have an easier time.

I was speaking to other friends, fellow interns and seniors who've just completed internship as well as registrars i've worked with before as a student, telling them how frustrating it can get as an intern, where you try your best to make things easier for yourself and everyone else. There is no escaping it. Either way I lose. When I make things easier for nurses, I lose because I become more busy, When I try to make things easier for myself by getting organized and doing tasks in advance, I also lose, because I just get more work to do. Such is the life of the lowly medical intern.

This is my first, and hopefully my last Medical rotation for the rest of my career. I have 8 more weeks of this to get through.

In my 2 weeks of experience, I think the way to make things as easy as it can get for an intern is to be organized and prioritize the work that has been give to you. It takes a while to get use to the way thigns are organized in a new hospital, ward, a new team. But we all get there eventually, and I hope they get easier with time.

where do I belong?

2011-01-01T07:06:00.000-08:00

I have just come to realise that being overseas for such a long time, even with the great experiences and memories that you take away, the main downside is that.. you don't make good friends like you do back home, but when you are away for too long, people from home forget that you exist.....

Epic trip - Surgical Elective to Cuenca Ecuador

2010-10-28T12:44:00.000-07:00

It has been a while since I last posted an entry. Much has happened since my last dated entry, and this is why i am finally penning down some thoughts about my surgical elective.

On the 27th of August I left Melbourne for my big trip to South America - specifically to Buenos Aries in Argentina and to Ecuador.

Cuenca, Ecuador and the Fundacion Cinterandes. This is where I undertook my surgical elective from the 19th of September to the 30th of October. The foundation started a Mobile Surgical Unit in 1991 and to date, similar programs world wide such as in Honduras and New Zealand. To date, the foundation has performed some 5000+ surgical operations in various rural towns in Ecuador. Procedures range from typical general surgery procedures such as herniorrhafias and superficial tumour excisions to gynaecological, opthalmological and urological procedures. The mobile surgical unit is also capable of performing more complex procedures such as Cholecystectomies both conventional and laparoscopic.

Before elaborating further, I will divide this entry into separate components, 1. Medical/Surgical and 2. Culture and People

Medicine and Surgery

Being able to experience medicine in Ecuador has been a very very rewarding and unforgetable experience. I had the pleasure of being immersed in both rural medicine and surgery during this elective. For 3 weeks of this rotation, I was in at a regional clinic or 'sub-centro' as they call in here in Cumbe, a small town of about 4500 in population, 40mins from Cuenca. Over here, we got to work with doctors, do consults to practice and improve our medical spanish and above all, the opportunity to experience a new culture and their attitudes towards western medicine. Making diagnoses with the aid of convenient radiological exams or laboratory tests are almost impossible here. Much of the management of patients invovles astute clinical acumen i.e. deciding if a patient has infective or parasitic diarrhoea or a viral illness - and whether to send them home with anti-parasitic or anti-biotic agents or allow the illness to run itself out. The arsenal of medications available for any infection include, Penicillin, Ampicillin, Amoxicillin, Metronidazole and Tinidazole. Pain and fever medications available are Paracetamole and Ibuprofen. Salbutamol for any respiratory distress. In order to get these medications for free, patients have to visit a goverment run clinic - medications in Ecuador from a pharmacy are expensive, and for the poor people here, it sometimes can be almost impossible to afford.

The lack of resources here often forces one to come up with new ideas and innovations to help the community - and such a baptism of fire is an invaluable experience. Home-made spacers from used plastic bottles that I saw was perhaps one of the 'innovations' I got to see being given to patients. Even gloves and handwash are hard to come by. Visiting one of the 'big' public hospitals, none of the above resources that I often take for granted in Melbourne can be found. You can't find a single bottle of Avaguard in an entire floor, that normally permeates the hospitals of Melbourne, or even glove boxes. All these things we take for granted due to its abundance in a first world country, are a luxury. Interns and doctors bring their own gloves, masks, scrubs etc.

Being part of the Mobile Surgery Unit with the Fundacion Cinterandes has been the best experience to date. The ability to provide surgical treatment to communities that would otherwise suffer with pain and disability has never ceased to amaze me. Whats is more, the success rates of the surgeries and complications rates are comparable if not better than conventional operating theatres in city hospitals of the developing world.

During these trips, we served as assistants in surgery as well as instrumentors or scrub nurses. Main post-op care was also provided by the medical students under supervision by the surgeons and anaesthetist. Other than the medical and surgical experiences that I gained by participating in this elective, personal reflection has also allowed me to realize how far I have come since starting medical school. The local more junior medical students would look to us in times of doubt, and under the appropriate situations would be able to provide the correct advice confidently and accurately, whether it was general medical/surgical knowledge or details concerning post-operative patient care.

Satisfaction, is an indescribable feeling; the feeling of contentment, joy, being proud of one’s actions but not necessarily with excitement, all put together. People who know me, know of my passion for surgery, head and neck oncology as well as plastic surgery, yet here I was helping out in straightforward procedures, hernia repairs, excision of superficial tumours, cholecystectomies and tubal ligations etc, and yet I was enjoying it. This was not evident to me, until a friend and colleague whom I was relating my experiences to said to me, ‘Jeremy, you have tasted satisfaction’. This trip has changed my perspective of medicine, delivery of health care and perspective of life itself.

Being a doctor is great. Being able to do something to change the trajectory of a human beings medical outcome or life is an amazing skill to have. This has now come to be my personal encouragement to work in medicine. The money, the prestige and respect that comes from the job whether earned or by association are important things in anybody’s personal life, but now I strongly feel that it is the intangible rewards that really keeps me going when the going gets tough.

Vacation time

Travelling alone has opened my eyes to the world. Learning a new language has helped the experience so much I cannot imagine how much less of an experience I would have had, had I not picked up Spanish beforehand. Before this, I use to have the impression that people who lugged backpacks around for trips that seemed to have no end were simply escaping the realities of life, to prolong the inevitable meeting with what they had left behind in the first place.....nothing much to desire.

But now, having met so many different types of people from all over the world, Germany, Austria, Brazil, Argentina, Ecuador, Ireland, South Africa, Korea.. I am incredibly envious of people like that. Taking a long trip is a huge commitment. A commitment to put life, normality, comfort zones on hold while one decides to leave and sometimes be a totally different person for an uncertain amount of time. Could I ever put my life on hold to pursue such experiences? If you asked me this question before my trip, I would not even consider that question worth answering. put my life on hold?!?! What about surgical training? writing papers? research? decorating my CV with all sorts of prizes and accolades?? I was a fool back then.

Now, all I want is to plan for my next trip. Fulfill all the experiences that I want and should have as a young person before stepping onto a train which is my career which has no end station. We are young once, youth will leave us that is for sure, but jobs are always there no matter when you return. That said, is easier said than done. Now having completed medical school, a new 'title' added to my name and another academic degree, we shall see where life takes me.

My trip has also shown me that, there is so much to see around the world, so many cultures to experience, so many different people to meet and so many different lifestyles to appreciate. I want to see the world, I want to live my life, the way I see it fit.

Gynae'oncology...death... and the cancer monster

2010-05-16T07:45:00.000-07:00

its 4 weeks into my gynae'oncology rotation and so far it has by far been the best rotation I have yet since starting the clinical years. I have been treated with respected and accorded the duties and responsibilities of a junnior doctor and never made to feel like I was a burden or hindrance in the team. The doctors, Kym the fellow, Annie the Registrar and all the consultants have been very understanding and nice. I could not have asked for a nicer working team. I was going to write about this on friday, but somehow things just got pushed to now, monday 1250am. Anyway, What I wanted to write about was a particular patient (DV) I have helped managed in the last 4 weeks. so last friday she was making those terminal groans and moans that all dying people do, and she was in pain. It was not a comfortable sight at all. And being in that same room with teary eyed family members wasnt an easy thing to deal with. The worst thing of all is knowing how things can change so rapidly. I saw her well and walking (despite her incontinence/fistula) issues, she was still alive so to speak. Now, it would be a miracle to see her still around when i turn up to the hospital tomorrow......I do not really have much to say or rather cant thing of anything else to put down.. but this I will never forget.

End of Gen MED....

2010-04-18T00:35:00.000-07:00

I've just finished my Gen Med rotation for 5th year and I must say I enjoyed it much more that I had initially expected.most fortunate enough to have nice and friendly consulant, registrar and resident. perhaps the only downside was to be paired with a moron, who has shit for brains. Taht being said, I have learnt immensely from this rotation. I personally feel that after the rotation, I' have indeed taken a wider step towards becoming a doctor. a much longer stride compared to breast surgery I must say. Writing, referrral, discharge summaries, pathology slips, radiology requests, scripts.. etc are now second nature. Clinical acumen, procedural skills and the like, I think i've made huge improvements in those areas as well. I got to DO so much more in this rotation than in any others from 3rd year,. This is the beauty of being a FINAL year medical student.much experience, and no responsibilities. My registrar feels I have a split temperament, suited for either surgery or medicine. As much as I enjoy the challenge of diagnostic and management dilemmas in Medicine, the lack of decisiveness and certainty makes it hard to bear as a career.

I cant see my self doing medicine, I think its for people with far more patience than I do possess. Patience, thats also one thing I feel I have improved on quiet a bit after having to tolerate the tomfoolery and foolishness of an almost clinically incompetent medical student. One still begs the great mystery," how did he end up passing high school?" much less getting into medicine. People ignorant of their ignorance greatly bother me, especially when I have to be patient and understanding; and allow them to share their opinions. I look forward to Gynae-oncology which is coming up next. Back to the operating theatre, where I feel I belong. the wards are a more cheerful place, but nothing surpasses the focus and decisiveness of a competent surgeon.

I actually am looking forward to be a Gen Med intern next year. But we'll see what happens, this "working" and not getting paid deal is starting to take its toll on me. 2 rotations down, 3 to go before my awesome elective in Ecuador. Cant wait. till then. peace

old and sick

2010-03-29T04:28:00.000-07:00

I have come to this conclusion with absolute certainty. I rather be dead than old and sick. It's very sad, for both individual and family, when one is old and sick, lying in a hospital bed with no hope for revovery; the only path is a slow, painful, seemingly unending journey to deaths door. Oxygen masks, endless needles, numerous blood tests to no good end...... the menial things human beings do to hold on to something that is as good as gone. I guess its easy for me to say now, but after having to bear witness to similar sights day in and day out, it just dosent seem like a big deal anymore, when death comes knocking at your door, even the newest technology wont help you breathe no more...

learning curve.....

2010-03-29T04:18:00.001-07:00

so in the past 3 weeks i've been taking 3rd year medical students, helping out with some of their clinical skills assessments and giving short tutorials here and there. it wasnt until today that I truly experienced what my previosu tutors must have felt, the frustration that one gets when students (while enthusiastic and eager) do not appear to grasp the importance of certain aspects of the teachings that Im trying to pass on. " Guys, please go home and read up on the following......." in the near future, " guys, can you tell me the following.....". 1st time, you give them soem leeway, 2nd time, you get frustrated, and 3rd time, you start to think that maybe, there was just something in the message that you are trying to put across is not CLEAR enough. its pretty damn frustrating, when 3rd year medical students still behave like they are in pre-clinical years; expecting to be lectured on and doing minimal self-directed learning. The learning curve when one gets to clinical years of medical training is a steep one. I'm very thankful I had someone to direct me when I was in 3rd year. Im jsut trying to do the same for other that come after me, to the best of my ability, and sometimes its just frustrating.

update 1 - needle-stick patient is HCV positive. so now I have to do blood tests for the next 6 months. damn.

unlucky

2010-03-17T07:06:00.000-07:00

today I suffered a needle stick injury. the patient has a hx of IVDU and ETOH, and is riddled with tattoos. blood test so far has been good. hopefully nothing bad happens from this. When i got home and decided ot heat up some soup, I forgot to open the lid up enough, and my soup exploded in the microwave. fuck me.

life and death

2010-03-16T05:09:00.000-07:00

today I saw a man literally come back to life. whilst the events had taken place over a course of approx 10 days, the progress has been remarkable. an elderly man who suffered a fall and a brain bleed, managed in intensive care and later recovered on the wards. Unfortunately for this man, he then developed blood clots in his lungs which sent him back to intensive care. this was where I first met him and heard of his story. The ICU is a scary place. Machines, tubes, needles, bottles, scurrying of doctors and nurses. Background noises of pumps, machines, patients coughing, choking, gurgling, the list is endless. Here I saw the same man, hooked up to the same instruments and looked after like every other patient with a serious problem. here every patient is broken down into numbers and percentages. the wonders of modern medicine are endless. where a man once laid on the brink of death, where family members had given up home on improvement and signed an advance medical directive. this man is now walking up in the wards, cheerful and talking. if you didnt see him over the course of the week, you could not fathom the strife he was in.

transition camp...2010

2010-02-27T21:27:00.000-08:00

so this year I decided to attend Transition camp, which is the orientation camp for 1st year medical students. It's been a while since my own transition camp and I was curious to take a look back in time, to see if I could recognize the changes that have taken place over time, in terms of my own maturity and development as a medical student. The last 2 days have been great. I think it is worthwhile for people to often look back and think about previous milestones in their lives i.e. first day of med school, first day as a medical student, end of first rotation in Final year etc...

confused looks aplenty, shy faces, and anxiety. The look of the fresh medical student on their first days of university learning. Only now that I think about 4 years ago, when I was in a similar position, do I ask myself if I was at that point just as clueless and helpless as these freshies. Certainly didnt feel like it, but most likely that was the case. As was I 4 years go, these new 'kids' have no idea the changes that woudl happen to them as they progress through the years; they might very well know where they will end up, but the journey and experiences ahead still remain a mystery. We as the tutors and guides at the camp impart our previous experiences on to them, hoping words and pearls of wisdom would give them a clearer path in which to navigate from the first day; and in doing-so I personally have reflected much upon my own change in the past 4 years, and also wait in anticipation of whats to come in the next 4 for me.

What's more amazing is the awestruck look, and reverence these first years have when they learn that you (or I in this case) are not a FINAL year medical student. It's like final year medical students have some magical powers to captivate and attract. These very same feelings I had, when meeting final year medical students of yesteryears. While it feels good, it also somehow imposes a greater burden on learning and the continuous pursuit of excellence. The most drastic change I feel is the difference in sense of uncertainty I notice I had, as a result of interacting with these bunch of 1st years in the past compared to now. I'd like to beleive Im quite the self-assured, confident and bold doctor-to-be right now, and no longer the 'unsure medical student'

this has certainly been quite the introspective experience for me. feels like yesterday when I was at this camp myself in 2006. and now, in only a matter of months I will have become a Dr myself, with real responsibilities to society. It scares me, but it excites me even more.

Final year

2010-01-23T06:52:00.000-08:00

so I just arrived in Melbourne yesterday and have now finally settled in to my new place. it is spacious, it is gorgeous, it is going to be a fun house. Final year will be a testing year, despite the 'relax' nature of it all, i intend to give it my best when im on the wards, clinics and in theatre. its going to be a taste of what is to come in 2011, and when that time I comes i intend to be fully prepared. 2010 is going to be an awesome year of fun, learning, and out of this world experiences. FINAL YEAR MED STUDENT, ECUADOR, SPANISH, MBBS here I come.

p.s. http://www.facebook.com/album.php?aid=2055511&id=212900539&l=e8e44f7bc9

check the pictures of my new home for 2010.

2010

2010-01-01T04:40:00.000-08:00

its been a while since my last blog post, and i attribute this to exams and also laziness, not that anybody is reading. conversations like this in my head happen quite often. I fear medical studies has pushed me towards a psychiatric condition.

jokes aside.

so 2009 has finally come to an end. What a long it was and what a relief that a new year has dawn on us, with so many exciting things waiting to happen. so my 4th year of medical studies have just gone by like that, and I have passed my final exams. unfortuately I did not do as well as I had planned to at the start of 2009. Resisting distractions and practising delayed gratification has not been my strongest suit thus far in 2009.

Being a final year medical student this year, I have mixed feelings about what lies ahead. I am excited about finally being at the top of the Medical student hierachy; where the juniors look upon you with this ardent fervour as I once did to my seniors when I was in 1st and second year. not having any more crucial exams in 2010 has been something all of us have been looking forward to since the day we enrolled in Medicine. My elective to Ecuador in September remains the highlight of my calendar this year. On the flip side, there is the pressure that this will be the final year I get to consolidate all that I have learnt in the past 4 years, to be a competent intern come 2011. On top of this, the pressure to have the knowledge that the junior medical students seek when on the wards; to not be outdone by the very same junior medical students in front of tutors and physicians. Knowing how easy it is for me to get caught-up in busy-ness or lull, I have decided that I will use the time that 5th year promises to provide to study well and be well prepared for the MRCS exam, which I will try and attempt in 2011. hopefully I see this resolution through with a good attitude; afterall i have bought the textbook. Mastering spanish to a competent conversational level is also on the cards as I prepare for my trip to Ecuador.

So now I am actually back in Singapore for the summer holidays and it really feels good to be home. It has been long since I have been able to enjoy the company of family, best friends and above all the comfort of home. I have mostly been going out, clubbing, golfing and playing games on the PS3. In the past 3 weeks, I have met more people here in Singapore than in Australia whom I will actually continue to maintain friendships. This has been something that I have long been missing whilst studying overseas in Melbourne. Being in the company of friends whose company you truly appreciate and enjoy, then the skin-deep, superficial patronage paid to you as a foreigner in a foreign land. having mentioned this, come June/July 2010 I will have to make a very important decision as to where I would be working in 2011. I know for sure, that I will pursue my internship in Australia and let things happen from there on. It would be the smart choice. But there is so much to consider when making decisions like that, job scope, training exposure, opportunities, salary, lifetyle, friends and social life etc...

Much will be happening this year, and there will be much to think about. For this moment, I will just immerse myself in the holiday spirit, focus on what is in front of me and not worry about what is going to happen.

Happy New Year to all, and may 2010 be a better year than the last.

obstetrics and gynaecology - the vagtastic voyage

2009-09-03T03:40:00.000-07:00

so 9 weeks of O&G has just gone by in the blink of an eye. The last 9 weeks have definitely been the most memorable experience for me in 4 years of medical school so far. Never before, have I been involved in a more rewarding health care specialty, where each clinic, theatre list or 8hour labour experience was never once a matter of going through the motions. In gynae oncology I experienced HARDCORE surgery, day in and out, on the Labour ward I experienced one of life's natural, most heartwarming experience, the process of childbirth; the smile on the faces of mothers after 8 hours of what seems like unending pain, the tears on faces of fathers after seeing their newborns. In the ante-natal care, the complex mechanisms of physiology, pathology and anatomy made even more challenging by 2 living systems existing in a mutually exclusive, yet interminable bond. I know, its an oxymoron. the experience over the last 9 weeks has seriously made me consider pursuing a career in O&G. Never before have I had something other than Reconstructive surgery exerting such a strong interest. truly, O&G is a specialty for the intellectual ones. The variety of topics one can encounter, from Fertility and IVF, Cancer, Urological issues, child birth, and even Fetal Health requires are all very enticing.
I'm rather glad, that I have had this unique experience which has not opened up my once close mind, in terms of career pursuits. while, I would have liked to maintain my original goals of a surgical career in H&N/reconstructive surgery, i would not have had the experience of searching for the one purpose in life that I can confidently say I would be willign to sacrifice everything else to pursue; which without would have been a great tragedy.

Paediatrics is next, which I am also very excited about. it will be 9 more weeks before the big exams start, which I hope I would do well in. The year has been hard and long. The light is getting brighter at the end of the tunnel.

vaginas and kids

2009-07-05T14:33:00.000-07:00

its 0745 hrs now, and im about 10 mins from leaving my house to start this new semester in Womens Health and Paediatrics, another gruelling - if not more intense 18 weeks than the last, before the year is over. I expect exciting times ahead, long hours but nonetheless interesting and motivating. GP and Psych are now put behind me, I didn't have to sit supps, so lets assume I was able to pass and did not fail. It is a good feeling. Not alot happened in the last 2 weeks - yes a mere 2 weeks of a holiday after such a long semester, and its back to the grind, reading books and watching DVDs, musicals and whatnot, a good relaxing period. could have been more exciting. Note to self - plan short holidays in advance in the future. The wimbledon finals was great, just ended a few hours ago. Although my player for this tournament - ANdy Roddick lost out eventually,it was a really really good match. Both players deserved to win, Andy more than Roger. But life is cruel, and I know Andy will be definitely be back with better tennis after this commendable but cruel loss. Better things to come in the future.

GP GP GP GP

2009-04-28T00:54:00.000-07:00

so im about 4 weeks into my GP rotation now. boring at times but learning alot somehow. Ive been assignmed to a fantastic GP, a really nice doctor who has been really patient and helpful to me as well as his patients. GPs play a really important role in the lives of people here in Australia, it is quite unlike what goes on back home, where the GP is more like a flu-medication dispensing clinic. Gp placements each week has been good, but the lectures on other days have been quite tiring. Today we had to tell a gentleman the diagnosis of MS. It was actually the firs time I had to see a doctor break bad news to a patient, and it wasnt the most pleasant experience. you could see the guy was outwardly devastated, having a bomb drop like that on a person, can be quite devastating.I cam into GP with some negative impressions about what was going on, just like Psychiatry, but its turning out to be better than expected. I guess i should stop letting first impressions or experiences of others to affect my perception. 5 more weeks to end of the semester, I gotta start working and do well and get these 2 subjects out of the way. Settled my elective for next year, ECUADOR HERE I COME!!!!!

regularity and containment

2009-03-19T23:45:00.000-07:00

so its been a while since my last entry, not that it matters since no one is reading this anyway. So psychiatry has been alright. started out quite alright actually, but then we had a 5000 word case report to write up, so 2weeks of the rotation was basically spent preparing and writing it. totally sucked the life out of experiencing psychiatry to its fullest. Imust add that the program hasnt had the best structure, and till this day, I am not sure what I've actually learnt. The doctors have definitely been great though. CATT, CL, block P, CAHMS; I've definitely picked up a few things from the frenlyl regs and residents.now is just a matter of me passing the exams. Anyhow, I was lucky enough to get to sit in with a family therapy session today. It is really interesting to see the dynamics that go on within a family. Even more so when the parents are capable, successful individuals, in this case, doctor and dentist. People also debate about nuture vs nature and how much each actually contributes to WHO WE ARE. This debate will never end, and we will never have a winner. it takes two hands to clap, and what one notices as an outsider really stirs curiostiy into what actually makes a GOOD family, and is there a perfect one? TOday - from the parents point of view, it seemed that they fail to accept the fact that their son being sick today, has nothing to do with their parental ways or their own personality, attributing most of the blame to their son and his intrinsic self. That might be true, but it seems the parents were forgetting that their son's intrinsic self was essentially passed down thru mendelian genetics, and that the family environemnt created by them as parents, and other social influences ultimately has lead to the patient ending up this way. Having said that, the son on the other hand was perhaps more resistant then any child I would imagine to be with regard to parental opinions. Notwithstanding the fact that he is in his teenage years and probalby has much going on shaping his perspectives and his sense of SELF; the amoutn of resistance he was putting up, was FAR greater than even what I would personally do to my parents. Even if my explicit self was defiant and aloof, there was still my conscience that took into consideration what others said; but this wasnt apparent in the kid in question. I was sensing some kind of a self-centred, narcissitic trait.

Its really interesting, and I guess no other profession really allows you to use the experiences of others to reflect on yourself, on yoru own behaviours, thoughts and emotions. It is quite a blessing to be part of the family of medicine.

also, ive just started with spanish classes. been really fun, and really hope to be fluent in spanish by next year. hasta la vista!

byebye Summer, hello 4th year

2009-01-27T04:25:00.000-08:00

its the last week of my summer holiday now, and the feeling that its coming to a close now isnt exactly the best. My elective ended last week and the experience I gained while over there was unforgettable. The lunar new year festivities have just begun, but as always, it is a short affair for my family, all the required visits done in one day. Can't say im a fan of the lunar new year, but it somehow felt good to be around this year, my first new year in 3 years. Also managed to squeeze in a game of golf or 2 during the time that I've been back though I wish I had more time on the course as well as the range.

Well thats all coming to a close now, and 4th year in Med school begins shortly. The requirements this year look quite ridiculous, >90% attendance and filling up + submission of time sheets, thats just crazy, NO TIME FOR GOLF!!!! oh well, shall make do and enjoy myself none the less, thats the only way to make the best of things.Its the year for my BIG exam, just another 36 weeks to perseere through.

summer holidays and electives

2008-12-24T05:59:00.000-08:00

so its been 3 weeks since my exams ended and I've since returned to Singapore. started my holidays with some wisdom teeth extractions, and that put me out of action for almost 10 days. Things have since settled and life has gotten back to normal. The weather in Singapore has been surprisingly good, relatively little rain so far and it hasn't been as hot as expected. The weather tonight is at 23 deg C, which is rare but also aided by the rain which lasted the whole day. Golf has been going ok, but not as well as I want it to be.Some new modifications to my driver, but my swing still requires some tweaking.

Currently doing an Elective in ENT at Changi General Hospital, and its been wonderful so far. The doctors have all been really nice, from the consultants to the MOs. only my 3rd day into the placement and with 4.5 weeks left, Ive learnt so much apart from the clinical medicine aspect of it. The spectrum of dieases, the patient mindset, career advancement and prospects in surgery that I've come to be aware of has opened my perspective of medicine to a whole new level. Also, from speaking with the team of doctors, I've somewhat had a paradigm shift in terms of my plans following graduation from med school, and my myopic outlook of a surgical career has been cleared up quite a bit from simple conversations with the various ENT doctors. Thats not to say I've been discouraged or anything. The challenges are tougher, but my motivation has never been greater.

More to come in the next month or so. I'm really glad i started on this elective.

2008-11-27T22:38:00.000-08:00

2008-11-27T17:19:00.000-08:00

short of breath....

2008-11-21T05:02:00.000-08:00

strange thing happened today, wouldn't expect it to happen, even more so with the hard work that I've put in. as usual, with most exams, I get trouble falling asleep the night before. But last night, it was quite a shock. Each time i closed my eyes, al I could feel was my heart racing, and no matter what I tried to think about or NOT think about, it wouldn't go away. What was worst, was that on 2 occasions, I actually felt short of breath and had to sit up in my bed to catch my breath before trying to go back to sleep again. I don't know how I got through today, must have been running on adrenaline or something.

I think i've been putting too much pressure on myself, pressure to be the best and pressure to not disappoint myself and it sort of backfired. Even more so, when I won a prize from the Faculty; I felt good at first, but then I felt I had to perform even better. it's only one more exam before the summer holidays start. Can't wait, this year has been too long.

2008-10-04T01:17:00.000-07:00

surgery and frustration...

2008-09-11T03:22:00.000-07:00

so today i decided to go up to theatre to observe some procedures by my tutor Mr Saunder after a long long hiatus from the OT. Varicose veins and stripping them away was on the menu for today. Not a complicated procedure at all, but watching it for the first time; it appeared quite brutal. Sticking the stripper into the veins after tying off the tributaries, making an incision on the opposite side, and pulling the stripper through, and what you have is the vein pulled out, inside out. avulsion of the varicose veins is what they call it. as the stripper is pulled through, you can actually see the veins underneath the skin tugging on the skin, bunching them up together, then with the intermittend breaks and snaps, the vein is slowly advanced out in jerky steps. and alter seeing it the second time, I thought to myself,' I could do this, dosent seem so difficult at all." see one, do one, teach one. but that would be so many more years from now.

the incident that took place after that was quite surprising to me. once again my tutor's cases was bumped off the list and he was made to wait well into the evening. I could read from his facial expression and body language that he was really pissed off at that happening so many times and had lamented the fact that because of his cooperation on most of the occasions he was being bullied. This let me to think, 'how is it possible that someone of his professional stature; with multiple administrative appointments remain calm and so in control of himself. Had I been in his position, i would have pulled rank, and used my authority to demand things happen for me and not consider the other cases on the list. I would have offended so many people and made myself one of the most hated doctors around. I guess sometimes its better to realize that letting such things get to you not only does not help the situation, it might also affect the surgeon's performance on his patients that day. The next time i find myself in a similar situation, i'll think back to this day.....

consultation...

2008-09-10T01:20:00.000-07:00

so today i decided to skip occupational health tutorials and sit in on the Neurosurgery clinic. This time of the year for me is Neuro Hx and Ex practice, and today musta been the best opportunity thus far. Not just sitting in, I was given a room to see patients on my own and then later confer with the registrars/consultants with my notes, to get them signed off. This afternoon would definitely be the first time i actually felt like I was a doctor.

sitting there one-on-one with the patient, in a consulting room. some of these patients had waited a couple of hours, but still they were happy to let a lowly medical student like myself assess them. Being post-operative follow ups, they weren't complicated or anything, neither did I have to diagnose them, but it was such good practice to do my examinations and histories and note subtle differences due to neuro-muscular involvement.

When I was asked to do a 1 on 1 consultation at the start of the year during the Vascular clinic, I was very very apprehensive and even scared. I did that with a final year student. But today it was different, felt like nothing could stand in my way, and was feeling really confident about my won knowledge and clinical skills. its also very interesting to note that several instances during the consultation, somehow despite my early mentioning of my medical student status, I was still asked questoins about prognosis; how and when they could return to normal activity. one patient even mentioned," i'm afraid to have sex, im afraid that if i go too hard at it, my neck will play up." and my response was," errr....ok.." and then later on, the patient did not mention this to the doctor, as easily as she said it to me.

thebreak i took 2 weeks ago has served me well. the studying is better, concentration better, and retaining and retrieving information has been good too. I hope to carry on this positive attitude and confidence as long as I can in medical school and as far as I can into my career, and making it better. each step of the way.

recovery....

2008-08-30T03:15:00.000-07:00

so the weekend is here, and im just chilling out. the past week once again was quite hectic and after each day i never felt more tired than before. Even my friends were asking me why I am looking so tired. so i spoke to Dr Ip and asked him for advice, on this mild burnout. Well according to him, people like me do not take enough breaks, and that's true. I feel guilty when i take breaks. and it is so hard to take a break and risk losing the momentum, especially in medical school where the knowledge needs to be at our finger tips everyday. But this weekend, i will take Dr Ip's advice and doing everything else but medicine. bought myself 2 books to kick back with, a 6 pack of pure blonde and some good ol' deli chip. recovery is the priority now......

lethargy...

2008-08-25T03:39:00.000-07:00

the last few weeks have somehow been exceptionally tiring. I would reach back home after each day and feel incredibly exhausted. and come the weekend, all i seek is to spend a quiet time recuperating. my social life is at an all time low, I haven't been out partying or meeting people in the last 6 weeks.

On the top side, I've been on top of my game each day in the hospital. Pwning others in bedside tutorials and answering most questions from consultants correctly during the clinics. Something in this formula seems to be going right at this point; while it's not the best balance as noted from my insignificant social life, I feel my knowledge and competence as a medical student has developed quite tremendously and each day i feel more confident about my own abilities. rheumatology has been one field of Medicine that I have been able to keep my interest in (also cos i've been quite good at it), other aspects of medicine have just been plain boring, the only other exception being Gastroenterology. Neurology is coming up soon, so hope that goes well. i just hope I can keep the faith and continue til the end of the year without burning out.

Two books I've read recently, "gifted hands" by Ben Carson and "Hot lights, Cold steel" by Michael Collins. both stories about the life and experiences of surgical training, which have been discouraging yet at the same time truly inspiring. It's amazing how these doctors can achieve so much. Being in medical school seems like such a huge task already but yet they've far exceeded their own expectations. I hope to be like that one day, even if it means 90% work and 10% play.

080808

2008-08-08T07:22:00.000-07:00

so today the date reads 080808, which in chinese tradition/beliefs would be perhaps one of the most auspicious days in history of mankind. chinesekind that is. today is also the opening day of the 2008 Summer Olympic Games, in Beijing China. Much controversy have covered the lead up to the games, but it seems like it's turning out fine. you can always trust the chinese to be well coordinated, efficient and impressive. Although I personally have an agenda against the mainland chinese because of their general uncivilized behaviour and uncouth like nature, i hope they pull off a good one, and not embarass the rest of the chinese looking people around the world, who may be subjected to a case of mistaken identity.

and i saw this on fb today.....

vexed....

2008-07-24T05:21:00.000-07:00

today the australian tradition of inefficiency was taken to a new level. inefficiency might not be the best word to describe this particular event. Waiting eagerly for my results to come in the mail, I was starting to feel something was amiss, when my results failed to show up like all my peers. But also having been away for the past month, I decided to look thru the stack of mail, that had the slim chance of concealing the envelope I so eagerly seek.

Did I find a letter from Monash University? I sure did.

Did the letter contain my results from last semester? NO!

What the letter did say instead, was that the FACULTY of MEDICINE was " your attendace at the year 3 formative exam was recorded as ABSENT" " It is disappointing that I FAILED to take the OPPORTUNITY to EXPERIENCE the format of 3rd year examinations" which were substantially different from previous years of study. The faculty also sought from my part "an explanation for my absence from such an important learning opportunity"

So I called them up and asked them what the fuck was going on. and it appeared just like in a David Blaine magic show, my script turns up in the pile of 'empty' scripts, the extras that weren't filled in, hence MISPLACED. I seriously don't expect such mistakes to take place in an institution of that like Monash, one of the BIGGEST and highest ranked universities in Australia, plus I don't pay FULL FEES for this to happen to me. Now, I have to wait again for my script to be marked and for the feedback and remarks to get back to me......

the medical interview.....

2008-07-22T01:28:00.000-07:00

so i've just finished reading this book " the soul of doctors". its a collection of personal experiences by medical students from Harvard Medical School. and it touches quite close to home the personal experiences I have since starting clinical rotations. one particular story that struck me the most was that of the medical student being turned down repeatedly by patients to take histories or perform examinations. He hated those patients and even more so their ignorance on their contributions to the teaching of future doctors. Not that I haven't been turned down before.

I've been turned away as many times before as the next medical student, but today seemed oddly different.While I use to bear quite a grudge on the patients that were unfriendly and stubborn somehow things were different today. Having set myself the task of seeing 3 patients a day this semester, I decided to start my day at the Gastroenterology ward today, to brush up on my GI Hx and Ex skills. Patient number 1 " sorry, it's embarrassing enough, my story, I dont really want to share it with students" Patient number 2 " I'm having trouble breathing right now, I'm sorry". I don't mind such patients who tell you from the start they did not like to be disturbed, the worst ones are the ones who agree at first and then decide halfway through to get pissed off and tell you to leave, those people are a huge waste of time, not just mine but the hospital's as well. But noot feeling defeated, I press on and I find 'david', chronic alcoholic who was at first apprehensive but warmed up and shared with me his life story. then came Mr R who was so obliging, you wish all patients were just like him. and last of the day was 'Mano' another wisened old man who was a great story teller. Because of his gregariousness, his history was a tough one to take as he often went off track. These 3 gentlemen restored my faith in the existence of the 'good' patient.

Alot of patient's really aren't aware of the amount of influence they have on a medical students development and their learning process. Every single patient, complicated or simple adds great depth to a future doctor's medical acumen. while i can understand their concerns for wanting their own privacy, there is really no other way for good students to become great doctors, without learning from the sick themselves. To all medical students out there, and those deciding to enter medical school, like everything else that you seek, good things don't come easy and persistence always pays off.

good bye 15May - Vua Hac Vua Lac

2008-07-10T04:39:00.000-07:00

today we had the English championship, the culmination of events in the past 2 weeks, to give the children a day of fun-filled activities involving games to reinforce the english they've been learning from us.

i woke up today with mixed feelings, and they persisted to occupy my thoughts throughout the day. We spent the morning preparing the school, hanging up banners, decorations, preparing the game stations as well as putting together goodies bags. At noon, it looked like it was going to rain heavily, threatening the days activities, but then the clouds held up and GOD gave the children a day to remember. I truly believe this was gods grace, he definitely didn't want the children to have a day of disappointment. The activities were scheduled to start at 1pm, but then at 130pm, only a handful of children turned up. This was somewhat depressing at first for us, and even more for the members of the EC component who faced so many setbacks and obstacles from day one of PV08. Thankfully, the rest of the kids turned up at 2pm, and the days planned activities went on as planned.

My mixed feelings were stirred mostly by 2 antagonistic views. Firstly, seeing the smile on faces of the children throughout the last 2 weeks and even more so today; I've never really felt happier and more satisfied with anything I've done previously compared to my time spent here with SEALNet. The second feeling is one of sadness; I feel really sad to say goodbye to them. I wonder how much we've done in the last 2 weeks will really affect them. Coming into this project, I knew that we could only do so much for them, but I truly truly hope that in 5 years time, If I get the opportunity to come back and see these kids grown up, they would have somehow with God's grace and blessings made good with their lives and continue to pursue excellence. What is worst is that I can't speak Vietnamese, so it was really hard to say goodbye to them. It was only in the last few days where these kids actually started addressing me by 'Jeremy', before it was just facial recognition.

Well, there is only so much that can be achieved in 2 weeks. I just pray and hope that these children will have good lives. I know they won't be reading these, but I want to say this to them, " I will truly miss everyone of you, (Thuy and Dao especially), you have changed my life and my perception of life. You have provided me a life lessons that I would treasure for the rest of my life and I can only wish that I have at least left some figment of an influence on you." " I will always be thinking of you and praying for you, but come next week we won't be around and I pray you won't be sad, continue to be a kid and at the same time be good."

PV08 Day 9

2008-07-09T05:33:00.000-07:00

today, the last event for the leadership component came to a close. the mentees, divided into 3 groups were tasked to come up with 3 different community service project proposals to benefit 15MAY School once SEALNet concludes its project here for 2008. I must say, and I believe I speak for most of the team, that we were all very very impressed by their presentations. they were all of exquisite quality and also very feasible and practical.

The presentations all displayed organization, good team work and also quite impressive public speaking. I personally feel a sense of satisfaction with the fact that we saw these mentees incorporate the skills obtained from our workshop and applying them so well, it exceeded my expectations; despite them being Vietnam's brightest bunch. Shang and myself were most impressed with the group which we supervised today (Picture-Dictionary group). They took our critique and tips, and improved their final presentations so impressively. In addition, the feedback we got from them about our series of workshops was generally positive, with some very very encouraging remarks.

During the past week, there were many occasions where we as mentors had doubts about the commitment of the mentees towards working with MAY15 School once we leave, due to the fact that a number of them raised the issue of being able to relate to these 'street' children. That being said, I believe we have a new found confidence in their abilities and willingness to continue the work we've done and bring it to greater heights.

On a lighter note, my good friend, Shangster annd myself have progrssed from 'Sao Zais' to 'Tep Zais', that is from ugly boys to handsome boys according to Dao and Thuy, the 2 cutest girls at the school.

I can't help but think how they would feel monday, when SEALNet no longer shows up to their school.............

Project Vietnam Day 8

2008-07-08T06:24:00.000-07:00

today has been quite a good one. Most activities went along smoothly and everyone was in high spirits, despite yesterday's emotional sequence. Because most of the leadership workshops have now concluded, i decided to help out with the english curriculum and got involved in some teaching. So this afternoon I helped out three little girls with their English, aged between 7 and 9. I find it very amazing that despite the language barrier, teaching another language to a child has not been as difficult as I anticipated. Given that more effort and time has to be put into the child during the interaction; the process taking place in the class room has been a very enriching and self-discovering experience. I never once expected I would be able to sit so patiently for 1.5 hours with a child, and more amazingly actually having them behave themselves. The interest in the subject and the enthusiasm for learning is truly AWESOME; even more so for children with such unfortunate backgrounds.

In the last 8 days, not only has the team worked against challenging odds to reach our goals, we have in the process also developed our own independent project which we hope to see become a reality. On the cards currently include:

1. Long-term Donation for Binh Loi shelter and Can Gio shelter, by means of an online system; which will also serve to sustain and develop the work that PV08 has done

2. Engaging NGOs to increase their awareness of such needs in some areas/communities of HCM.

3. Increase awareness of the work by PV08, by means of a project blog and possible website.

I really hope to see the fruits of our labour go a long long way, whether it last 1 month or 1 year or even 10 years, the impact this project has left on us individually, the children, and the mentees will be a milestone in all our lives.

PV08 Day 6 + 7.

2008-07-07T10:44:00.000-07:00

Day 6

The past 2 days have been rather intense in terms of work schedule. full days of workshops to conduct + a very early morning start to Can Gio, to visit a rural shelter. Alot has happened in the last 2 days and several emotions have been stirred. this is where i shall start my blog entry tonight.

several emotions were stirred a few days ago during our nightly debrief sessions. some group members felt somewhat inadequate in terms of their value towards this service project, while the leaders of the project felt that the project was coming apart as some members of the team helpless; and they could not provide direction.they even cried. Sometimes, I feel that when people take on responsibilities and tasks, they tend to stray from it. I don't necessarily mean this in a bad way, i.e. shirking off responsibilities. What I am trying to say is, we often set lofty goals and these goals may be far beyond our own capabilities. When these tasks aren't accomplished to our expectations, the feeling of dejection and failure becomes a greater insult. This however, does not give us an excuse to settle for mediocrity or 'average'. This is one of the main lessons that I have taken away from my experience with SEALnet so far.

Visiting Can Gio today was quite an eye-opening experience. Seeing the state of living in the community there was quite surreal. Given the 3rd world status of Vietnam, one can still find it hard to believe that there are still places around with living conditions so poor, one would classify them below rudimentary. I could not imagine myself growing up as a kid in such a place, and I thank god for blessing me with such a fortunate life thus far. We spent most of the time playing children games with them, some might find them really silly, but just seeing the kids enjoy themselves made it all worthwhile. We even took them out to the beach for a few hours of fun, if we weren't there they would not have other means of going out of the compound for fun0filled activities.

Tonight's dinner has been the most fascinating to date. I actually tried some half-hatched duck eggs, steamed to cook. It actually dosent taste that bad, pretty much like a mild salted duck egg, or a century egg. but then I was curious and decided to perform an autopsy with my innate surgical skills, with the rest of the table like an audience of eager medical students.

Day 7

During our time here, we also have several 'professional' mentors. Their alleged role is to provide MENTORSHiP and guidance for us the PV08 team members. But so far, all they have done is actually nothing more than create more unnecessary emotional tension. I know they have no intention of doing so, neither do they wish to compromise the dynamics of our team. But perhaps, they could have been more astute in their judgments which would have avoided some hurtful comments thrown out in the spur of the moment. Not only did this meeting not serve and positive benefits, it was very frustrating, and no doubt left a dent in our framework. But these have now been resolved, and there are more important things at hand to address. The mentees have started to rebel against us the mentors and we find it an increasing challenge to balance between accommodating their needs without compromising their learning experience.

On a lighter note. I must comment on the varying standards of Vietnamese cuisine i have been experiencing. The Pho restaurants have been great, and so are some of the swankier restaurants. that being said, we have also experienced restaurants which got our orders wrong several times, took ages to deliver our orders and last but not least the BADDEST tasting chicken rice or Can Ga I have ever tasted. The rice was tasteless, the meat cold and the skin LEATHERY. Truly disgusting. In the words of Shang, 'definitely a gustatory insult, that would leaves more to be desired"

SEALNET PV08 - Week 1

2008-07-05T06:10:00.000-07:00

On the 30th of June, after a somewhat sleepless night, I boarded SQ178 for my adventure in Ho Chi Minh City, Vietnam. Some people still call this place Saigon, but that is besides the point.

Arriving at the airport, I was received by Thao aka Viola who also happened to be a Medical student where we waited for another PV08 participant Azusa from Japan. After leaving the airport for the Le Duy hotel, the thing that amazed me most was the HCM traffic. motorcycles aplenty, cars, vans and taxis abound, the vehicles weave through the roads and alleyways with complete disregard for traffic 'rules'. Zebra crossings have no significance, as do red lights. With this in mind, if anyone actually observed 'conventional' traffic rules, one might find him/herself in an accident pretty frequently. road lines also seem to be merely a formality, as vehicle traverse the lines carelessly, and I find myself sitting in a vehicle destined for a head-on collision. In addition, motorcycles weave in and out of traffic; mothers with toddlers in arms, ladies with stilettos as well as grandmothers. many a times I have found my life hanging by a thread, whether sitting in a taxi or crossing a road.

Arriving at the hotel, I had a wash up, and decided to 'explore' the surroundings. Knowing that petty crime was frequent, I decided to only venture to a nearby mall.It took me 5 minutes to cross a 2 lane road, which seemed effortless to locals. even on a '1-way' street, I had to look both ways before crossing; while walking on the pedestrian pavement, I had to look out for moving motorcycles; such is the state of HCM traffic. If anyone can cross HCM roads with ease, they would be jaywalking kings anywhere else in the world.

The team so far has been amazing, people from all over the world. Japan, Malaysia, USA, France, Cambodia, Singapore and Vietnam too. It is quite amazing how all of us, stranger to each other, gelled so easily together from day 1. Many of these other group participants from very prestigious institutions yet humble and practical/logical perspectives. Having been assigned to the leadership group, we were in charge of conducting leadership workshops as well as playing mentor to HCM's brightest high school students. These students have been quite impressive. Shy and reserved at first, they have slowly but surely evolved into confident young adults. Their standard of spoken english has also been quite a pleasant surprise.

Seeing the 'street' kids at the May-15 school of HCM and the mentees, it is quite shocking to see such a drastic difference in living standards. On one side of the room you have students with handphones and digital cameras and on the other side, students who have troubled family backgrounds, living conditions so poor, basic clothing and food are even a problem. While some can afford to spend all their time studying, the other group of students go straight to work after school, and work late into the night just to help out their own families. children in singapore are so fortunate. even the least fortunate families have guaranteed education, proper homes and enough food.

The SEAL NET project this year aims to lay the foundation in 3 areas.

1. Creating a basic computing program for students aged 6-11
2. Imparting Leadership knowledge to mentees
3. Creating a sustained interest in English learning.

So far most of the programs have been running quite smoothly, albeit some problems occurring with the english program as well as the computing program. But with this amazing group of people, I am quite certain this project of ours will be a raving success. ranging from 18-24 years of age, the diverse talents and qualities we each bring to the project is invaluable.

50% doctor...

2008-06-09T00:14:00.000-07:00

so its now the last week of my first semester in 3rd year of medical school. how time flies. even before even though it seems like its been ages since the first day of clinical placements, 18 weeks has gone by just like that. Turned 23 last week, no dramas there. More importantly after these 18 weeks:

1. importance of breakfast
2. articulating/voicing your knowledge is more important than keeping it in your head and putting it on paper
3. for some people, even after 18 weeks of placement, still remain lazy and unmotivated and I will be having to deal with such people when i actually start working
4. an efficient self-study/revising method should be out there, for the existing one is not working well enough for me
5. unhelpful and unfrenly patients dun deserve my sympathy; especially those who waste my time by acknowledging an interview and then cutting it short halfway --> you people dun deserve the nice frenly doctors, but that is ok, I will still wear a smile in front of you.
6. I need a new study plan for semester 2, to make myself better, to destroy all other students who try to challenge me; especially when I know I'm right.

Anyways, the winter break is nearing and I am very excited about heading back to Singapore to see some friends I have not met in 2 years. Things will be getting crazy from the 15th of June. Can't wait. Even more exciting, my trip to Vietnam to teach English will be an experience that is second to none, it being my first service project that I actually self-volunteered to participate in.

until next time.....

oh check this out...

theatre time....

2008-05-15T02:32:00.000-07:00

so today I scrubbed in on a procedure, quite a minor one, but nonetheless supercool. cute little 2 year old boy must have been mischievous, coz he fell face first into the ground and suffered a lacerated tongue. the laceration must have been around 3.5 cm long, jagged edged and quite gory I must say. quite lucky I have a friend who is a Max-Facs surgeon in training, and he allowed me to put in half the stitches to put the little rasclas tongue back together. its really amazing how some simple suturing in some ways is "reconstructive", especially in this little boy, his tongue. Tongue = Speech + Taste + Appearance.

and my multi-purpose reflex hammer arrived today, so its been a good day.

waking up late...

2008-05-02T06:13:00.001-07:00

waking up late to the realization that you are late for bedside tutorial is no joke. Furthermore, having only 4 hours sleep the night before only makes matters worst. But most importantly, I skipped my breakfast today, brisk walked to the hospital and rushed up 4 flights of stairs....so i found my group and we shortly went to see a patient.

it was diabetic patient and as we went on, we came to the issue of neuropathy and how proprioception and vibration sensations are affected first before temp/fine touch discrimination.

and at that instant, somehow, my leg went numb, like it freaking disappeared, I couldn't bear my own body weight, and collapsed to the ground. I didn't faint, I just fell. Freaking hypoglycaemic event, compounded by some dehydration overnight.

The importance of breakfast I assure you, cannot be stressed more.

guitar hero

2008-04-20T02:12:00.000-07:00

well im definitely no guitar hero. But this game is AWESOME. Haven't played such an addictive game in ages. The songs are awesome and hitting the notes just never felt better. I didnt see the appeal of such games until I tried it for myself, it is a really good social activity, gather a couple of close frens together and battle each other or co-op to try complete the most difficult songs...... Im quite glad I dotn ahve it on my own, otherwise my studies will be taking a back seat. many many awesome songs on this game. I've also been watching these videos of insane guitar hero players who seem to complete the toughest songs with such ease. Takes alot of commitment I must say, more commitment than a medical student to his studies. IT scares me that peopel can play so well,clearly their lives outside of their Wii or Playstation world are quite limited.

Check this out.

why the fuck are Local university students so poor??

2008-03-25T22:43:00.000-07:00

so I'm now in the midst of my easter break and I have done zilch for study, but that's alright I need all th motivation I can get and hit it hard when uni starts again next week. The parents are in town to visit, and I've been palying tour guide most of the time. Took a drive up to Mt Dandenong on Saturday morning which was pretty pleasant, had a taste of the famous pies they made at Pies In The Sky which was quite good, but didnt get to try the scones from miss marples. Other than that, its been golfing and more golfing. Holidays = GOlf, what more could I ask for, and we're going again tomorrow. The Irons are working really well for me these days, but im still having trouble with the incurable slice that has been a huge impediment to my game.

Interesting news I came across in the local paper today. " STudents' SeX For CASH" now that totally caught my eye. Apparently Monash Uni students are turning to prostitution to fund their education. Apparently students are' being forced to work long hours' in addition to their studies to pay basic rent, and the president for the Students' Union has called for an increase in the Youth allowance, eligible youths get, which apparently is well below poverty line. According to this guy," students have to meet lots of expectations and society isnt giving them a chance to meet those expectations, as they have to commit lots of time to work instead of study."

Well, what i have to say about this is FUCK U ALL. First of all, the locals don't have to pay their fees upfront, even if they do, its 20% of what international students have to pay. If they're living from home they have zilch to pay for, if they move out, then it's only rent they pay for. So where the fuck does all their money go to??? someone i know made a huge fuss about being asked to pay 60bucks more to live in a room twice the size of everyone else's. She's 20 and she cant make the decision to pay 60 bucks more, she had to ask her parents. Seriously, if you don't pay your school fees, and you get YOUTH ALLOWANCE, where in THE FUCK IS ALL YOUR MONEY??? Most International Students I know have very few issues when it comes to payments that invovles basic necessities. But it is understandable when they say they can't afford it, because it is true when you are paying 40000 a year compared to everyone else who pays 8000, WE REALLY DONT AHVE MUCH MONEY LEFT, but we never make a huge fuss involving 60 bucks a year, 5 bucks a month, 1.25 dollars a week.

I don't care if your parents are farmers or doctors or janitors, prioritize your own fucking money, spend less on booze, shoes and clothes, girls dont need 20 pairs of shoes and if you're hot it dosen't matter what you wear.

when they say life is unpredictable, they mean it....

2008-03-06T02:21:00.000-08:00

today I learnt that this patient I saw on quite a few occasions to take a history, do an examination or sometimes just simply stopping by and having a chat and see how he was improving had died 2 days ago.

On the first day of my INfectious Diseases rotation, he was a very sick looking man who had just come out of a valve repair procedure, as a result of bacterial endocarditis. He was barely able to speak coherently and was vaguely aware of where he was. As the days went my, he got better, starting eating better, was slowly able to walk on his own without any aids and in a week or 2 he was looking well on the road of recovery. I must have gone by to seen him around 5 times, which dosent seem alot, but when you compare that to the average number of times medical students see patients its 5x as many.

so this afternoon, I overheard my ID resident speaking to the nurses about what happened and was pretty shocked to hear the news. It is really quite saddening to see a young man who was planning to turn his life around after the disease go just like that, in a finger snap*. What happened??? A ruptured spleen, from multiple emboli that caused multiple infarcts in the spleen. and simply bled to death internally.

oh well such is life, and he will probably be one of many people i shall be seeing in my career as a doctor but he'll probably be the one I will always remember.

the inverse pyramid....

2008-02-29T19:01:00.000-08:00

if its something that I've learnt so far, is that other than the biomedical knowledge they teach you in 1st and 2nd year, interview/history taking skills clearly fall short.

They use to say, be sympathetic, empathize with the patient, ask your open ended questions to get ALL the information. What they didn't say was, when do I stop the open ended questions? when is it ok to interrupt the patient and ask questions that you so desperately seek answers to, so as to get a clear and detailed picture as to the events that precipitated and the presenting complain itself.

As it turns out, empathy for patients dosen't really matter in the end. Get the information you want, and start processing and thinking about what's wrong. However, the patient feels towards you is irrelevant, if they need you to make their life better, they won't hold back information from you no matter how big a prick you appear to be.

Lesson no.1

Start with the open-ended question.
'Hi, can you tell me why you had to come to the hospital?"

Pain? - character of the pain, quantity of pain, radiation of pain + associated symptoms. What made it better, What made it worst?

Think about possible symptoms involved in the presentation, and illicit all risk factors and systems review(prioritize questions) as soon as possible. The patient having High Cholesterol is more important than the fact that he had a hip replacement 15 years ago. What happen before the patient fell thru the roof is more important then the fashion in which he fell or how many bones he had broken.

6 minutes, thats about all the time to take a complete yet focussed history, before taking another 6 minutes to do an examination of the relevant systems.

In the meantime, I'll be busy memorising the 1 million causes of clubbing, the dynamic heart manoeuvres, the signs of severity of AS/MR.

7am CBT this morning, now I'm totally shagged out, with more study to do.

Think 3rd year is slack?? think again...while the intensity is manageable, the volume is surely intimidating.

3 weeks in...

2008-02-22T20:07:00.000-08:00

its been 3 weeks into 3rd year, and i must say its been really exhausting. even though the timetable is flexible, somehow I still find myself studying quite a bit, so much to know everyday at the hospital, so much to see and even after as much reading you try to accomplish you still feel pretty darn stupid.....more or less settled in to the routine of self-directed learning and seeing patients to practice physical examination skills. take some effort to pull myself to the hospital every morning I must say...but its all been good so far...

in the meanwhile, ive been watching some inspiring videos...

all settled in.....

2008-02-02T00:51:00.000-08:00

bought my bed, a new high back comfy 'Managerial Chair" for the long hours of study I anticipate, a Dust Buster, a nice rug, to keep the dust off my feet and into the room, I love this room. My first 'OWN' room, furnished and put together myself, less the fixed items like the wardrobe......and more unsightly stuff like boxes that will leave eventually.. clinical years at MMC, bring it on....I've been put together with a group of students I've hardly spoken to ever before. maybe one other girl, I've said a total of 15 words in the last 2 years....guess i'll have to make the best of it and CRUSH THIS SHIT!!!!

and by the way I can take on 25 5year old kids all at once.
25

back in Melbourne for 2008

2008-01-28T04:33:00.000-08:00

arrived in Melbourne early this morning. perhaps one of the most boring flights i've had so far. There weren't many good movies to watch except for the Heartbreak Kid which was pretty good. " Screw OFF!! I'm just joking...... - Uncle Tito"

Terminal 3 is really quite nice. good shops, restaurants, everything just looking really perfect, would love to see that place again.

Apart from that its been a pretty tiring day, unpacking and arranging my new room. I have since moved out of Richo and am now staying with 2 fellow course-mates. 2 girls that is. It is going to be an interesting year ahead. Adding on to this, formal lessons in lecture theatres and classrooms is at best minimal and a thing of the past. pretty excited to see real patients and real medicine in action. some drama perhaps?? Grey's Anatomy-like hopefully.

now the hunt for the perfect mattress goes on, big enough for 2 but not so big for 1. heh. a year of good nights sleep beckons, but for now i'll have to do with the one in my room, which is keeping me awake, hence this blog entry.

back home...

2007-12-06T08:48:00.000-08:00

so I've been home for 1 week now. and it has been incredibly boring.Pretty much spending most of my days at the driving range getting use to my new set of Golf Clubs. Callaway X-Forged irons. Which are SOOOOOOooooo SWEET!. I totally love them. you never go wrong with either callaway or forged irons. after 3 days at the range, I'm pretty comfortable with them now, just have to maintain my swing and slowly raise my sswing speed to get that ball flying further.

OH, I'm also damn relieved and grateful I DUn have to take supplementary exams. Thank GOD!!!! I can totally enjoy my break now....

rain rain go away, come again another day, or perhaps go visit somewhere else that needs you more than Singapore. somewhere like Melbourne.

going home.....

2007-11-24T22:47:00.000-08:00

so tomorrow afternoon I catchmy flight back to Singapore. Dosent feel that special anymore, the feeling of going home after a year. it seems like I'm pretty much settled in Melbourne, and tavelling back and forth has becoming something i've gotten used to. Time flies by really quickly i must say. It wasn't so long before, when I was also waiting to go home after a long year at uni, and now i am at it again.

I'm really looking foward to the holiday nonetheless, its going to be a good break(fingers x) after a long year of assignments and study, distractions...and what not. Just wanna sit back, kick back and not have anything to think about for a couple of days....

the lull period.....

2007-11-21T21:27:00.000-08:00

exams have been over for 1 week now, but it feels like ages ago....and even though it's over now, a huge burden still sits on my shoulders. I can't help but think of the possibility of doing supplementary exams. guessing 60% of the time thru 220 MCQs is actually quite scary in retrospect. well I hope I did well enough not to be called back for those exams, although my preparations won't the best this time around, I did put in effort for this exam. well, i'll know in a couple of days how things will turn out.

the halls are pretty quiet now, most people have already moved out. didnt do much since the exams ended but chill out, watch movies, South Park, visited the SEXPO on Sunday, which wasn't as exciting as I hoped it would be, but it was an experience nonetheless. Got hooked onto a golfing game, Shot Online 2007

, which is so awesome. its keeping me rooted to my seat and staring at the laptop for hours.

on to better news, I shall be returning back to Singapore in about 4 days. Quite excited about that. Will be playing so much golf back home, I just can't wait. bought myself the Ping Rapture today for a pretty sweet deal, 350 bucks for a DEMO.
It's not brand new, but its gonna be USED anyway.

until next time.

exams looming...

2007-11-03T17:10:00.000-07:00

its been 2 weeks since the last day of school. and time has really flown by just like that. OSCEs are coming up in a couple of days, and the big exams are just over a week away. In addition, it only less than a month before I find myself back in Singapore for the summer. Study has been going slowly. Gonna have to make some sacrifices and buck up. I sure as hell don't want to fail 2nd year. Its been the biggest bitch of my education so far.

On another note, I was in church today, and one guy fainted. The good thing is, he turned out alright, and nothing too serious happened. The fucked up thing is, I just stood there too shocked to do anything, or even respond. I'm not gonna let this happen again. and MED2042 I'm gonna come destroy you!

assignments out of the way...

2007-10-20T06:43:00.000-07:00

with assignments out of the way FINALLY!!!!! it is sadly time to hit the books for some serious study for the next month or so, before the fun and relaxation. the few weeks has been a mad rush of presentations and submission of assignments. Never before in my life have i been so busy before. Those weeks seemed endless, but now that it is finally over, I am truly glad.....recently bought myself some Valerian for better sleep and Ginko Biloba for better concentration, though I suspect some placebo effects with such supplements, anything that will give me a better advantage with studying is worth trying.......peace.....

Richardson Hall Halloween 2007

2007-10-03T20:27:00.000-07:00

halloween party last night awesome, people came in the craziest outfits...I myself was suited up as the Hamburglar. 1st prize goes to elliot Eu....for coming as the pants-less RObin...with greased hair...and a tight top...questions floating about his sexuality last night i must say...th epartty had a slow start....but once things kicked off at around 930...it was just good....if only more people from other halls were involved, it woulda been so much better.... crazy times..I'm gonna be missing Richo next year...

golf golf

2007-09-24T17:29:00.000-07:00

recently tried out the Callaway X-Forged irons....and they were awesome...

med ball 2007....

2007-09-22T00:33:00.000-07:00

spring break is finally here and what better than med ball to get things started. last night was perhaps one of the best nights I've had since the last Med ball. This year's event took place at the Royal Exhibition Building up in Carlton, and it was an affair to remember. I'm not sure I am able to describe it much, you'd have to be there yourself to experience the awesome-ness of the night. but it has been a while now since my last binge drinking episode, and I must say things aren't that well as I type this blog. it could've easily added up to 15 drinks, of a various combination of beers, wines, champagne and spirits, but it wasn't so bad that I can't remember...

At the Ball: 4 wines, 3 champagnes, 6 beers

After party: 2 Beers, 1 bourbon-coke, 1 pineapple malibu, 1 Jaegger bomb

so its actually more than what I first recalled... a few sculls together with Tim lindsay and his rugby mates, i coulda sworn, put the nail in the coffin...

overworked, overloaded, over my head......

2007-09-14T06:05:00.000-07:00

the last 3 weeks has been an exceptionally busy time for me...after my rural placement, it was just a mad rush to finish assignments. rural was quite a good experience this year, because I felt i actually spent time leaning important things, and being in Bendigo made things alot easier from a rural context. nice big town with everything you need, and very interesting architecture too. but i shall not dwell into that, as I can't be bothered typing out the events that took place. but I must let everyone who reads this blog that, Nman aka. Derrick is the man, the fucka cock blocked me in recent events that took place in Bendigo.

anyway, the last week after rural has been crazy, spending 3 day in the library from morning till closing time.writing a stupid assignment that only makes up 5% of my total marks for 2nd year. on top of this rural fortnight has also thrown at me another 2 assignments. more and more reflective essays. fuck!!!!!!! tuesday night I actually did not get any sleep, was up till 630am wed morning to go thru the fucking SPC assignment, and in the end having to skip the morning lectures, so that i could get in a few hours of rest before heading to the library for another day of revision to the essay.

I am having many issues with the way monash handles its curriculum and the kind of tutors they engage, firstly some of the tutors aren't even doctors who can't even give us proper clinical information during PCLs, and other clinical skills tutors who use 2 hours to teach us the theory of physical examination when we are meant to practise it. something is seriously wrong here. Last year, I had excellent tutors who alwasy shared with us their own experiences in practise, while this year its just been a pain to be at tutorials. How is reading out what reaserch you have done to a class going ot heplt he learning process, when everyone has already read it before?? it neither stimulates thinking nor draws further interest to the subject?? fuck this.....

oh well im really glad that one assignment is sorta out of the way but the many many more ahead is just fucking annoying me. good thing I attended the Richo ball last night, good times I must say. and if it is one thing i learned on an alcohol induce event, less thinking = more action = more fun = good times. This i shall practise at similar events in the future.

3 exams down....1 to go...

2007-08-24T23:22:00.000-07:00

the mid-semester exam for MED2042 is finally over. now just one more final exam, before real medicine. going thru the exam script yesterday, I reckon i did pretty alright, should be able to pull off a Distinction, which I would be happy with, anything better would be a bonus.

a number of events are coming up for me, Rural placement, and Phantom of the Opera. going to bendigo this year, with a group of students that are 80% Asian. Good fun I say, imagine a whole bunch of Asian kids in rural australia, where people who haven't seen non-white people other than their own indigenous people actually exist, place where some people may or may not have telephones and television. but i guess this is a good break from school. I'm going to have to maximise my time spent in Rural, plenty of assignments to submit this semester, so i'll have to finish some, so i can put them aside, and not let them get in the way of my final exam preparations.

Went on a shopping trip today. not so much as to buy things i needed urgently, but rather to make use of my very very awesome Country Road privileges. $100 discount when you spend $300. and for 200 bucks, i got my self a new pair of shoes, a bag, and a Neck Tie. shopping in Australia is always more awesome then back home, where the sales are rubbish and the variety is severely lacking.

So time has really flown by that quickly, and only half a semester, 7 weeks or so left till the end of the school year. I only hope to make the best of what's left....

lazy crap...

2007-08-14T00:34:00.000-07:00

some people involved in group assignment can be incredibly lazy, and at the age of 19 have not a single ounce of fucking initiative. and stop fucking behaving like you ahve done plenty for the group, when even the most important part of the project was taken over by someone not even involved in the project. FUCK you!

many falls, bumps, and soggy pants and socks later....

2007-08-11T06:32:00.000-07:00

Snowboarding is DEFINITELY the BEST sport in the world.initially quite a challenge to pick up, but after a few runs, nothing else can truly beat the exhilaration of carving the slopes, charging down at top speed, and at the same time praying you down fall and break something. today's weather in Melbourne, was just wet. Wetness in the city is good, but pelting rain on the mountain top is almost suffering. but when engaging in some as exciting as snowboarding, you just tend to forget about everything else. today's visibility was in a sense PITCH BLACK, just think everything in WHITE. you literally could not see further than 5-8m in front of you.

People might think that cruising down the slopes is effortless, but only those who have ever tried will tell you how much it taxes your quads and your calf, and when you fall over, it hurts your wrists..... but it is definitely worth every minute and cent of it.

no life....no interest...no interest in life.....

2007-08-10T05:39:00.000-07:00

the past few weeks have gone by quite quickly. been sick, been tired, been sick and tired. but i've since recovered. the lectures have been quite intense and the workload just never ceases to increase.i slowly feel the pressure creeping up on me, and finally what it means to be in medical school has never been as clear. last year in perspective, was a complete joke compared to this year. as i look ahead into the weeks to come, i see essays and more essays, essays to reflect on projects and essays to reflect on what you have just reflected on. this need for reflection in a medical curriculum still befuddles me. finally got back the results from the delayed exam, and im glad to say I did quite ok. managed to scrape a distinction. it was quite unexpected i must say.

the group assignments aren't going as well as i wanted them to be. it seems that in 2 groups of people im working with, i have to constantly be the one to keep abreast of what is going on, and push people to get their work done.i dun mind taking up this role, but what pisses me off the most is people lacking in initiative, people who see difficulties and try to find easy escapes immediately, this morons dun deserve to be doctors.

my next exam is one week away. and with everything to juggle, i can only pray for the best.

I'm going snowboarding tomorrow, its going to be good, and better still to just get away from everything.

boredom.....

2007-07-30T07:56:00.000-07:00

Intellect + Style = My image of the 'doctor'

and just adding a teeny bit of sleek to top it off.....

vroom!vroom!

bad newssss.........

2007-07-19T00:47:00.001-07:00

The exam yesterday was a terrible mess, the questions on Microbioloy were just like the organisms we were meant to know about, A fucking annoyance. Certainly dosen't give any confidence to any one like me taking an exam and going thru a dozen MCQs, and not knowing what was going on, and worst of all not being able to eliminate the choices to narrow down answers. I've totally wasted the extra month we were given to prepare for the exams. What is most annoying and disappointing, is that despite knowing the consequences of last minute exam preparations, and foreboding unimpressive grades, I still wasn't able to kick myself in the arse and get myself studying.

Good vs. Emo/Evil. I wasn't quite sure what the theme of the party was last night. Highlight of the party would definitely have to be the jackmeister himself Jack Griffin himself dressing up as Jesus Christ, and doing an awesome job at blasphemy as well as sending his own ass straight to hell when the times comes. (no love lost for you mate).

it's been a while since I've experienced bad news in my personal life. and the most recent one, being this morning didn't come well at all. brushing aside 5 missed calls last night from my family back home while I was getting myself inebriated, I woke up this morning, to another phone call from my mom, telling me my grand dad had passed away. Heart failure---->Postural Hypotension----> syncope----->trauma----->hemorrhage----> death. it freaks me out to see myself seeing the pathology of the sequence of events, without having felt a sense of loss. perhaps its just me, perhaps its the whole idea of medicine that has desensitized me. perhaps its just that I haven't had really bad news told to me in a long time, that i've just forgotten how im suppose to feel. but life goes on.....

studying studying.....

2007-07-16T17:23:00.001-07:00

its the day before my long overdued exam. been camping in the library for the past 2 days, shoulda done this much earlier, been getting more work done than back in my private cave. fuck..... what needs to be done has been valiantly attempted, hoping for the best tomorrow, but expecting the worst. peace out....

lethargy...

2007-07-12T00:12:00.000-07:00

the past few days have been dreadful. I hate feeling lethargic and exhausted. even with my alarm clock set at 830am, so that I can get up for a morning gym session, I end up rolling out of bed at 1030am. Something is amiss. sleeping at 2 am is not an excuse, as I lived and breathed 5 hours sleep sessions during my high school and army days. stupid exams, everyone else is chilling out except my own tired-ass....fuck.

my study plans are going no where....

2007-07-09T08:26:00.000-07:00

my study plans are going no where. distractions abound. shows to watch, movies to see, and girls to sarge.

back from Tassie..

2007-07-01T07:38:00.000-07:00

so i got back from Tassie yesterday, but just too tired to blog till today. I must say I'm very glad to have visited Tasmania. Amazing scenery. i'm definitely going to make a trip back for the adventure stuff and check out more scenery. Some of the highlights of the tour included the Cadbury Factory Tour, the Cascade Brewery tour the drive up to Mt Wellington, AMAZING seafood and not forgetting the delightful scones at Shot Tower.

Putting up at Zhi's place was good. Saved myself a good deal of money. Tried out his ride, a souped up 350Z, possibly the noisiest car I have heard so far. Proved my mettle in whipping up tantalizing medium-rare steaks. Well now, what do I think of Tasmania.

Basically a rural environment, the only city-like place being Hobart located far down in the south, a 3.5 hour drive from Davenport. Davenport and Launceston are basically huge rural towns. you don't see buildings taller than 20 stories with the tallest building in Hobart being Wrest Point, the Crown-wannabe. Most of the homes being built by the hillsides along the coast in a stepped manner, gives all the residents an excellent ocean front view. Weather in the mornings can be dreadful. upon disembarking from the ship, the FOG was so thick, one could not see further than 2 car lengths in front.thankfully such driving conditions did no persist throughout the trip. On the whole, the weather was somewhat similar to Melbourne, perhaps a few degrees lower on average, at this time of the year. Seafood in Hobart is amazing, and so are the fish and chips.

Despite being a small place, to explore Tasmania sufficiently, would require at least a 2 week trip. Getting about is not easy if you do not have a car as the only means of transport around is by BUS. there are numerous places to explore, from quaint lodges and cottages to taste amazing Aztec Chilli-Choc Mocha to soft, mouth-watering scones at Shot Tower. A delightful spread of oysters awaits seafood lovers at Barilla Bay out in Sorrell. People who love to drive, will thoroughly enjoy the drive throughout Tassie, with speed limits at 110 km/h and very very beautiful scenery along the way.

The links below will show you the photos I took during the trip, its too many for a blog.

http://monashedu.facebook.com/album.php?aid=2025578&l=f8e4e&id=212900539
http://monashedu.facebook.com/album.php?aid=2025579&l=0292b&id=212900539

For now, its back to hitting the books for the postponed exam.

NUS is possibly the most ridiculous Tertiary Instituion yet

2007-06-24T21:53:00.000-07:00

after learning the shocking news that NUS Faculty of Medicine had decided to accept the applications and offered places to 2 Poly Graduates, they have placed the final brick into the wall of disdain that I built for them. Not much more can be said of their idiocrasy, and their insatiable need to make headlines with the most ridiculous of achievements. For example, actually believing they are 18th best Univeristy in the world, ranked ahead of universities like Columbia and U.Melbourne. Nonetheless, this amusing instituition of higher learning never ceases to amaze me in the crazy little things they do.

when procrastination becomes sloth.....

2007-06-23T06:18:00.000-07:00

so the 3rd week of my extended Swot Vac has ended, but still I have yet to accomplish any of the goals I set upon before. Revision wise, I have only covered weeks 7-11 of the lectures, now that's only 2.5 weeks of work, as weeks 9 and 10 are irrelevant. Head and neck anatomy went pass quite quickly but i have yet to review the larynx. In place of this revision, what I have done instead, is finishing seasons 1-5 of my new addiction Scrubs, in 1.5 weeks, and I must add season 5 in 8 hours. Also, i have finshed reading 2 very very intersting books on surgery which I have mentioned in earlier posts. you will find that this blog is particularly because I have some mental notes on the book which I would like to put down to paper.

Firstly, "Complications - A Surgeon's Notes on an Imperfect Science" by Atul Gawande, now this man is a Harvard Medical School Graduate, koodos to that. One of the chapters that stood out was 'Whose Body is it Anyway?'. Now in this chapter comes the endless debate about paternalism vs. patient autonomy, very relevant to recent developmetns in medical school education, involving the indoctrination of the belief that 'What the PATIENT wants supercedes the DOCTOR's recommendations'. This debate goes far back, to the time where doctors were idolized and worshiped, and from that pedestal, whatever being said by the doctor was the absolute truth. No Questions Asked. Then came along, a doctor by the name of Jay Katz, author of the revolutionary book 'The Silent World of Doctor and Patient' which had strong critique for the whole idea paternalism, which obviously did not take too well with the current mindset of clinicians. some would say, ' if doctor's have difficulty choosing the best options, how can the patient then be capable of doing so?' Patient ideology vs. Treatment outcome. In my opinion there is no hard and fast rule about this. Some patients feel that to live a life with some fear of a returning cancer, by preserving a social image is more important to them, hence choosing a lumpectomy over a total mastectomy, some will be smarter. Of course there are many considerations here, patient's age, degree of metastesis, patients occupation and other emotional, psychosocial babble. Now having being socialized into the medicine paradigm, naturally I would raise my hand for the treatment that boasts the best MEDICAL outcome, and whether a patient decides to follow your lead is purely their business. Now you might say, ' where is the empathy that doctor's are suppose to have?' Like I said before, it depends on the situation at hand, while a doctor may recommend a radical mastectomy for a 65 year old post-menopausal woman, he may not do the same for Kylie Minogue.

Whilst inundating the patients with a mountain of information regarding their options and then leaving them to decide might be the 'cover-my-ass' way of having a malpractise free career (as much as possible), it most certainly is not fair to the patient. At the same time, patients who say," don't tell me all that stuff doctor, i won't understand it, do what you think is best." also is unfair to the doctor. Then comes the idea of a partnership, that is being proposed in my med school, where the lay person with his -5 years of MBBS education but lifelong learning from Wikipedia and Google actually has a more important decision making role. Certainly even when give this position of authority, one question comes to mind, who gets the blame when something goes wrong? Is it the doctor? or is the patient left to live a life carry the burden of his mistake? At this juncture, the idea of a partnership ceases to exist and the blame-game starts. Such decisions which can lead to life and death situations carry a huge burden, neither the patient nor the doctor would want this. childish regression from the patient partnership vs. Aggressive Paternalism. The debate continues.

i quote from the book," whilst there is an art to becoming a doctor, there is an art to being patient." this is absolutely essential to YOUR/MY overall treatment outcome. just because you choose to absolve yourself of all responsibility in decision making, or decided to disregard the expert opinion of your doctor, a good and CLEVER patient must always question the doctor about the treatment. Ask questions that pertain to your lifestyle, how is the treatment goign to affect your work? can you play sports as aggressively as before? what ultimately is important to you in your time of sickness? These are all important questions, as they help the doctor in determining the best treatment for you. If patient's don't tell, doctor's dont ask (well good doctors like the one im going to be) will ask, and when you sign the form acknowledging the potential risks involved, i hope patient's don't start behaving like morons when things don't turn out their way. doctors make countless decisions everyday, some of them in emergencies some not. so the hard and fast rule of the ethicist about being partners cannot always be applied. These people, especially those without MBBS should realize that their idea of ULTIMATE patient AUTONOMY cannot exist in a blemished society. Whilst doctors must always act to serve in the patient's best interest, patients must remember that doctors are only always HELPING them, and the thing to do is to voice concerns and TRY to work towards an agreement, rather then play the blame game later on. This debate will continue for as long as existence goes and will only get more complexed as patient are enlightened by the resources of google and Wikipedia.

One quote i would always remember is " the real task is not to banish paternalism; but to preserve kindness."

What i really like about this book, is how it gives a really good insight from both perspectives of the patient and the doctor. As it the pages open to exciting surgical stories, it also brings with it important lessons that have strengthen the foundations my current MBBS education is giving me, allowing me to see the bigger picture of medicine and also understand that whilst some classes in med school might seem irrelevant now, they are absolutely important in any doctor's career.

crazy cold....

2007-06-15T01:49:00.000-07:00

its been 1 week since the last day of school, and a good break thus far. The weather has been rather insane as of late. Early mornings being around 2-3deg C and average day temperatures hovering between 8-12 Deg. played insane golf, in antarctic ocnditions on tuesday, and random city stuff on Wed. I've been spending too much money as of late, fuck I need to get a hold of myself.

The Gym routine has been going well, and I'm not snacking as much,but thats possibly because my snacks were devoured in a space of 2 days and I haven't been able to get of my ass to get more...

to anyone who might stumble upon this blog, DO NOT WATCH ZODIAC. It is perhaps one of the longest, most boring, and retarded movies ever made, especially when you are made to share a bean bag otherwise known as the 'love sack' thats meant for a cozy couple with 2 other people instead. Am I going to write a movie review here? I guess not, it pains me to think of those 3 precious hours i wasted my life away...
On the side of the books, i've been able to get my first step down in revision, starting with anatomy of the HEAD and I've been reading these 2 books; autobiographies of a surgical adventures. the first being Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande and Brain Matter: The Adventures of a Brain Surgeon by Katrina S. Firlik.

Haven't completed them yet but I'll be sure to put my thoughts about them down to paper pretty soon.

The weather today has been insane. all FOGGED up, and you can't see further than 100m I reckon. not a safe day to drive.

Done with Med 2031!

2007-06-08T02:00:00.000-07:00

I just can't belive how fast medical school is going by.It seems just like yesterday when I got on the plane and came back to Melbourne to start 2nd year, and now I', half way through it. 6 weeks of Holidays ahead, but then i'll have to study for the stupid exam that got postponed. This past semester has been really relly hectic and exhausting. I've seriously never felt so drained and at the same time STUPID. Going to school everyday attending lectures that seem ok, but walking out of them totally clueless as to what was going on. Back in my room, reaging book after book, and feeling like nothing is being absorbed at all.

Reflecting on this semester.Haven't been as participative in class as I wanted to be this semester, so think will have to change after the holidays. The social scene has been okay, despite the immense workload, getting to know more people and not having to put in as much effort as I thought previously. i'm looking to get a good break this holiday, work on my golf and hit the gym as often as I can. Really excited about Tasmania which is coming up in a few weeks.

In the meanwhile, I shall have to force myself to finish some miscelleanous assignments for next semester, get them out of the way so that I can maximise my Free TUESDAYS, yes I say again FREE TUESDAYS next semester. I need to organise my study material and get my anatomy up to mark for the exam. Timetables haven't exactly worked well for me till this day, but i'm going to have to get into a more regular routine. I'm going to make myself proud next semester. fuck yea...in the mean time, its time for PFE at The Croft Institute which is going to be so awesome..

4th June 2007

2007-06-05T03:49:00.000-07:00

and so I turned 22 yesterday. 1 year older, 1 year wiser ......had plenty of birthday wishes coming in, mostly on facebook, that seems to be the latest fad in communication these days, and i'm getting addicted to it. I hope. Not being a fan of birthday celebrations. I did the usual small dinner with some close friends. and what better way to have a good meal than possibly the best steak around at Hog's Breath Cafe. the Juiciest and Chunkiest prime ribs you could find, is here. I must admit I was very surprised when Shuwen sneakily went off, to organise some really really good mudcakes to be served after main course. I had a singing waitress too, who was quite attractive. so that was rather delightful. bithday songs in public still bugs me though,never once felt comfortable having that song sung for me ever.

the weather is getting much colder, and waking up in the morning is getting harder as the days go by. Finally handed in my CPP report, which took ages to complete. 1 Assignment down, and plenty to go. OSCE formative exam is coming up, but since its formative I just cant be bothered.

can;t belive it already the last week of the semester. after this the holidays, then a new semester, and very quickly the end of 2nd year. How quickly time flies.

5th of June, that is today. something happen that totally made my day. it was a simple gesture, but from a special someone.

fuck you idiot asses....

2007-05-25T05:07:00.000-07:00

bollocks...today I learnt that the exams are gonna be postponed till after the holidays, in the 2nd semester. totally killed my mood. destroyd my momentum.my study was going good, putting in a few hours every after school in the library, getting organised, and now it feel liks someone stuf a freakin pebble in the middle of the road, when i'm goign down hill at 80km/h on a skateboard... university, swotvac....what the fuck seriously, its only becoz of a few days, and some ill disciplined morons had to make a complain. so many generations of doctors before went through the same system before us without any problems. no doubt the MSA was acting in our interest. no one is blaming them. we blame the morons, who would be our colleagues in a few years time, who made this petty complain.

Now the exams are 8 weeks away. and worst of all my holiday is ruined. somehow i'll have to go through with it, doing my assignments, entertaining friends from singapore, travelling to Tasmania and revision. ARGGGGGGGHHH, just feeling really pissed off right now.this is really really frustrating. guess i'll just have to manage and be flexible. no worries, good doctors always rise to the occassion.

Haven't been waking up according to schedule lately. and according to my good fren Zarif, " You Snooze, You lose"
which is actaully very very true. for two consecutive days, I snoozed, and I end up being almost late for classes. FUCK. I need to change something. Gym sessions have also somewhat been reduced lately, for some unknown reason.

I need to get my act together. Today, is the end of a week, and let the new week ahead, be the beginning of a change for the better.

waterpolo with kids......

2007-05-14T04:39:00.000-07:00

one of the best saturdays I've had since starting med school. buying groceries, heading back to my room, watching a couple of movies was pretty much how my saturdays usually went, throw in a few hours of trying self-directed learning. BUT TODAY, I got myself involved in a Waterpolo Clinic for Kids. and how cute they are, especially the few who's name I got to remember, Maverie, Keallie and Rhys. Really adorable kids. This clinic goes on for another 2 saturdays, and I am definitely going to be part of it.

and sunday..... Inter-Halls swimming competition once again. guess who rocked up a splendid performance once again??? me of course. haha. Whilst last year it was more of a one-man show, this year we had a great team. Good participation from the girls and another amazing bloke by the name of Trevor, terrific swimmer. once again Richo prevailed, and this time I won the 25m Fly I narrowly lost last year. we SWEPT the relays, and there was no 2nd guessing who the champions were going to be once again.

monday.....I know this seems like a combined blog of the weekend, but I can't help it. my discipline standards has plummeted to embarassing standards as of late. School is back on track once again. seeing everyone again. setup my wireless internet after more than a yaer of procrastination. and with this I have made a new resolution. On days that I do not have evening activities, I will take my study to the library, away from distractions.I got one month left to the semester exams, and I do not intend to give myself excuses for dismal results. The next few days are going to be hectic, HPKM ethics submission is due, CPP is also due soon, and exams are in a month.

damn i really hate assignments. especially when they are irrelevant and take up precious study time. But I shall persevere.

and lastly, last day of CPP tomorrow. WOOHOO!

finally the end of CPP.....

2007-05-11T16:44:00.000-07:00

its been a very very long 3 days at Billings Method this past week. I decided that for once I shall leave slightly later at 830am, since CPP didnt really matter anymore, not like the people down at the placement really bothered with whether or not we were late or punctual. I still managed to reach Fitzroy 10 mins before time. Melbroune Rush hour traffic, heaviest between 745 and 815, after this, its much smoother. When I use to leave at 8ish, I usually reached Fitzroy just on time. Buggar, I coulda have 30 mins more sleep every tuesday morning. oh well, what's done is done. These last days at Billings have been rather rewarding compared to our first few days there. We got to meet the pioneers of the Billings Method, Dr Lyn Billings and also Prof James Brown ( the man who came up with the progesterone/oestrogen chart/graph during a menstrual cycle)it was really an honour to be in the same room as he was, having seen that graph over and over again in school studying biology not so long ago. our CPP project finally came into harvest. we decided that Billings on the whole was dull and boring and havent't had any avenue for advertisement, since they were pretty much quite tight at the pouch. So we came up with perhaps the most beautiful pamphlet ever, eye-catching and elegant. it was pretty much Hiep's work alone, but we all gave ideas. heh.

Finally back into the pool playing water polo. for the 2nd time in my life, i've never felt so tired ever before. this sentence is kinda wrong, but what the fuck. Urban week has come to and end, it seems that I have just tossed the 2 weeks out of the window. There were so many things I wanted to revise for my semester exams, btu at the end of it all, i can't quite remember what I did, school wise. This is seriously very poor discipline and time management. I gotta do something about it.

Lastly, the weather has been getting colder as of late, getting more and more difficult for me to get out of bed.damn it. And I made the decision o go down to Tasmania during winter. Looking forward to that.

Teacher Training Course.

2007-05-01T05:35:00.000-07:00

CPP once again. This time, I had to make my way to freaking Eltham, which is sitting on the brink of RURAL-hood. GOt lost along the way, so that certainly didnt help the 45 min drive. Chart after Chart after Chart. 930am to 530pm. It was like going back to high school, and sitting in class, one after another. It was perhaps one of the most tiring days I have ever had, related to school work. now im having back spasms. Having said that, today was perhaps one of the better days of the placement so far. At least now we are learning important things. The billings method is more than just a tool for fertility. by recognising the patterns throughout the ovulatory cycle, women empowered with this knowledge would be able to recognise unusual physiological changes, more than just to detect fertility or infertility. rather, they would be able to take this awareness, and go to a trained medical professional for further assessment. this would definitely be a big step in the direction of preventive medicine especially int he area of womens health. I would definitely teach this method, once I am equipped with the necessary skills to friends and family who want a greater sense of self-empowerment.

Lunch was definitely good today. gourmet pizza. met some great people too. not exactly looking forward to tomorrow yet, as it is going to be another long day, but it would be enriching none the less.

fuck you monash city council...

2007-05-01T05:24:00.000-07:00

headed down to MMC today for my 'Buddy Visit'. I chose MMC for the visit this time around, as I already have been to the Alfred before. Contrary to popular belief, it really isn't a bad hospital to do clinicals next year. The final year student, Chole was really helpful, way better than the final student I had last year. I ahte seeing final year students though. everytime I see one, i am reminded of the many years I have left till the beginning of the end. well, it never really ends in medicine now does it?

Was very fortunate to meet Max today. Perhaps the most enthusiastic patient I have ever met so far. Never would I expect a recovering patient from a 3ple bypass would be so keen on letting medical students like myself, who are clueless about anything, take his history or perform a physical examination. 78 years of age and still full of energy. a stark contrast from the other patients in his ward, who weren't as 'frenly' so to speak. But we can't really blame them, the last thign any recovering patient would really really want, is a bunch of medical students coming in and using them as tst subjects. Anyways, to Max, I wish you a speedy recovery, and I shall always remember what you told us. " As long as YOU learn something, I don't mind you doing whatever you want with me." " You have to be the best at what you do, because its you guys who will be looking after patients like me in the future". your words, I will take with me wherever I go, whenever I look at any patient. Thank you so much Max.

on a more messed up note, I received a damn fine for parking my car over the duration alloted. and now i have to pay 54 bucks to the damn city council. fuck this.money hungry SOBs. don't understand why anyone would put parking restrictions on a road that is perhaps 2.5 lanes wide. better luck next time I guess.

CPP on a friday night...

2007-04-28T07:24:00.000-07:00

so they told us, that there was much to be done for the registration and setting up at the opening night of the Billings Conference. bollocks, no one was to be seen when we got there at 6pm. The conference was organised to begin at 730pm, so we tried to leave uni as soon as class ended. But we found ourselvs to be relatively early. after 10mins or so of setting up soem laptops and projectors, we were pretty much done. driving 30 kms all the way to heidelberg just to do that, was quite a wate of time.

fortunately, we got a chance to have a mini discussion with Dr Mary Martin, who is a Gynaecologist who is in provate practise in the United States. The session we had with her was really insightful and enriching. I must say, having a very experienced gynaecologist come in to spend some time with 2nd year medical students was really time well spent. not only did we get her insight on the Billing's Method, but also some lessons in medicine. The pill...end ovulation...hyperinsulinaemia...... increased insulin and its effects on circulating androgens...metabolic syndromes...pre-diabetes in women, and the relationships with fertility. It was quite a bit in that one session, 60% of medical jargon that I did not understand one bit, even after 1.5 years in medical school. This is why I chose the Billings Method for CPP last year, not to be some slave worker, packing hundreds of envelopes and photocopying 100s of door bags. i'll give this another chance, hopefully once the conference ends and the teacher-training session begins, we'll all get what we were orginally looking for..

the next 2 weeks are rural week, so the urbanites like me wil be having a more relaxed time-table. I gotta make sur eI use this time wisely, get alot..and I mean ALOT of studying done, as well as some HPKM stuff. perhap sI could get a few rounds of golf in the 2 weeks. we'll see.

tired, exhausted and a general loss of interest in life...

2007-04-26T08:11:00.000-07:00

dear diary,

went out clubbing tonight. its been almost a month since the last time i went out. Long Room along Collins St was the venue for tonights forae with my good fren, shuwen. good fren she was, when she interrupted me as I was running my game on this chick, damn it. This place serves good alcohol, and by that I mean Asahi "Super Dry" Beer.

Almost died early wed morning. Never felt the exhaustion and fatigue after a long night of clubbing to this extent before. decided not to stay over at shuwens place, and instead drive home from the city at 5am in the morning. Most fortuantely where weren't any other cars on the road, as most importantly I was driving slowly and carefully. But a momentary lapse in concentration, led me to dozing off at the wheel. eyes shut for one second and I almost found myself driving straight into a road divider. Thank god nothing happened.

MEd school is getting more and more tiring each day, stupid project proposals to do. It just takes up too much time. My regular gym routines are slowly dwindling, in part due to lack of time, but most recently due to sheer exhaustion after a long day at school. My weekly weight record shows that I've been in the 70-71kg range over the past week, this is not good. My ideal weight should be maintained at 69kg. Following the exams last week, the night snacking regiment has not stopped. Though Is nack on healthy stuff like muesli, they pack a deal of carbohydrates, and It hink this is the main culprit in my recent weight gain. Gotta get back into the GYM regiment.

Went back to water polo for the first time this year. It's been a long time since i felt so exhausted. cramps and more cramps, was the main experience I had during the hour+ long session in the pool. Met Catie's boyfriend, who schools at Deakin, but decided to come down to the Monash club. what a small world.

met a SUPER hot chick at the gym today. but my blue balls syndrome set in. damn. I hope to see her again sometime soon.

paintball.....

2007-04-21T06:37:00.000-07:00

yesterday,I was conned into joining the society I so vehemently avoided last year. All I did was want to play paint ball, but I had to join this dumbass association. fuck. Paintball, good fun and excitement. That is if you go with a good group of friends. this group unfortunately weren't my friends, but a bunch of retarded individuals who come from the same country as I did. this group of idiots and morons, and one individual in particular, dosen't understand english despite growing up in English speaking Singapore and now studying here in Australia. This fucking retard dosen't give regard to any safety rules at all, blardy bastard putting 3 pellets into my side, when only standing 2m away, and best of all after the game was declared over, because I won the game for my team. Fuck you, you stupid son of a bitch, mother fucker, rot in fucking hell and have a tragic death.

1 Exam down, 3 more to GO.

2007-04-18T22:21:00.000-07:00

the first mid semester was finally over yesterday. I would say i was fairly consistent over the past 7 weeks, but somehow, when it came down to the crunch, which for me would be 1 week before the actual exam, the number of pages, number of pictures and volume of text, seem to somehow grow by unimaginable proportions and the helpless medical student, in this instant myself, is left to fend for himself, with TIME as his indomitable enemy, and his laptop and caffeine shots as the only weapons to wield.

I cannot believe teh amount of work we medical students have to cover.back in Alevels, it was a narrow scope with a somewhat fair level of detail to cover, right now, its a scope that stretches beyod the horizons, and a depth of detail required that goes beyond conceivable proportions. this was only 7 weeks worth of work, at the end of the year, I would have 54 weeks worth of study material to cover, and not to mention, the totally hectic, but totally irrelevant project assignments that we have. but now that the first hurdle is over, I shall take a few days off, that is, perhaps reduce my amount of study to 40%, and from week 8 onwards, its back to the books. I need a plan, a RIGHT now plan. Long term plans and desires of fast cars, big bucks, and beautiful women can take a back seat, becoz the RIGHT NOW plan will be in action.

1. Do pre-reading for all lectures.
2. Do self directed learning prior to all Anatomy/Clinical Skills tutorials.
3. Weekends - Revision or more detailed research for personal understanding.

That would be the plan I hope would make me more prepared and more confident for the next exam.

On the brighter side of things, I cut up a man's face today. I broke his jaw, and picked away at the tissues, until they were clean, leaving behind only what I was required to see. My right now plan will make me a surgeon. That is the only way.

Torquay Day trip!!!

2007-04-10T05:03:00.000-07:00

Dear diary,

this post was meant for yesterday. ANYWAYs, the cut-short easter break that my fellow medicos and myself have been hustled off has been going well, study has been going well, been able to concentrate when it comes down to it, dedicated attention and focus, just like ADSL, dedicated bandwith.

Sof first things first, headed down to torquay today with joshua and his sister joanne and his cousin Diana. Tried surfing for teh first time today, and I mst say it was mighty awesome, definitely worth another trip back there.IF i could go down every weekend, I just would. The whole town is just so laid back and into the surf culture, you dont see any form of industries over there, just small offices, cafes....that and other stuff. but what you do see are MASSIVE, and I mean MASSIVE Surf shops. surf shops the size of Nike Melbourne, which could easily be half of Borders book store, the one back home in Singapore, not the fucked up ones you find here, which are no bigger than Dymocks. All this just a 90min ride away.

today 100407, first time i played golf in 3 weeks perhaps. had quite a good game today, the best so far since coming down to Melbourne.Hit will with the irons and had a few good tee offs, just a bit short on the putting aspect, which I must seek to improve. 1 more day to the end of the so called 'break'. Its gonna be full on studying from here. till next time.

dont hold back.

1 week break.....

2007-04-04T23:44:00.000-07:00

finally the first half of semester 1 is finally over. easter break beckons, but there is merely another way of saying, "it's time to study, exams are just around the corner"

I hope to achieve some serious academic breakthrough during this break, and get some good marks for the exams. that aside, time must, and will be put aside for some recreation which = Golf and possible some surfing down at Torquay. HPKM wise, project is ahead of schedule, we've been able to organise good group meetings and accomplish our individual tasks, so that has been excellent.

DEMO DAY!! headed down to the Melbourne Golf Academy where they were having demontrations for the latest in Golfing equipment, and I got to try out almost every new driver there is on the market, including the FT-i, the SUMO^2 from NIKE, the Rapture from PING as well as the R7 from TaylorMade. I must say I really enjoyed hitting the Callaway X-20 Tour Irons, nice straight, long shots with the 6 iron. Wasn't really feeling it with the Nike CCi Forged Irons. as for the drivers, SUMO^2 seems really good, and the noise on impact is insanely loud.the balls were flying quite straight despite some slicing on my part, due to lack of skill. but none the less the effects were quite obvious. Favourite DRiver of the day though, was the PING RAPTURE with 10 Deg Loft and R-Flex shaft.

I promise to make the a part of my golfing gear in the near future:

I found my social suicide girl.

FINA World Swimmming Championships 2007

2007-04-01T07:15:00.000-07:00

waterpolo at it's best. it couldn't get any better today at the Melbourne Sports and Aquatic Centre (MSAC) as it is known in short. Spain vs Serbia for the Bronze and Croatia vs Hungary, all the big names in waterpolo. Serbia the pre-tournament favourite and world no.1 ranked team narrowly lost out to Spain in a long and ardous penalty shootout, whilst perenial waterpolo powerhouse lost to the current olympic champions in the Gold medal match. I must say the 78AUD was quite well spent. It will be some time again before I will get to catch waterpolo at a world class level.

you wouldn't believe how humongous those guys are. think of WWF wrestlers in bathing suits, slamming balls into the goal post at 75-80km/h. that is absolute power and agility.

other than this, the weekend did not prove fruitful in the academic department. once again got distracted by TV shows, and the ongoing swimming championships. Australia's performance has been rather dismal, the men in particular. Hackett failed to shine in his pet events and was dethroned as the king of long distance. Thorpe, who's absence I guess made a huge impression on the overall morale of the team. The women however were outstanding to say the least. USA, was just brilliant and Michael Phelps incredible.

Exams are in 2 weeks, and there is so much to cover, together with these bullshit assignments that we have to do.Easter holiday is just around the corner.looking forward to some golfing during that week, but it would mostly be spent preparing for the mid semester exams.

Behavioural Change Project. Time Mgmt vs Exercise. which should I focus on?? I reckon the one on exercise and weight loss will be a fair bit easier for me to write on and actually put detail into it.Having said that, time mgmt is something that I should be focusing on, seeing the amount of work inundating us this year. BOLLOCKS!!!!

the production line.....

2007-03-27T03:07:00.000-07:00

10...15? maybe 20 boxes...... envelope after envelope, newsletter after newsletter, the repetitive motion of slotting one into the other, one fluid motion. Community Placement Program, or CPP is more like exploitation of free labour. furthermore, it's not like we 2nd year med students dont already have enough work on our timetables. The school just has to throw in such pointless, time wasting activities for us, to include in our assessment.

Putting together a couple of hundred envelops together individually, among the 6 of us, was not easy task. Repetitive and Mundane.

drained.....

2007-03-23T22:46:00.000-07:00

this week has been particular exhausting.the reasons, still unknown to me. went to the gym twice, which is not as much s I would personnally have liked. This week was so tiring, I actually woke up, sat on my bed and pondered, and decided to skip the morning lectures and just go for tutorials in the arvo. consecutive 6-8 hour days aren't exactly doing justice to the mental and physical health of the monash medical students.

On top of that, the amount of Self-Directed learning that we have to do on our own is immense. Pharmacology+Anatomy+Physiology and throw in some bull shit lectures on health promotion and learning how to use the internet.This is serioulsy frustrating.
Cardiology is over, and now Neurology. Cranial Anatomy alone was quite a shocker, this weekend shall be spent mastering it.

CPP this week was a total waste of time. Took a 1+ hour car ride at 8am in the morning into the city, to sit around and ponder about this thing called the learning agreement.Thereafter, we were asked to come up with a manifest or inventory or nominal roll, depending on how you wish to call it. Allocating delegates into hotel rooms and adjusting them to their requests. to do more justice to the people who actaully did the majority of the work, sophie and annie, your work was much appreciated.

Thai food. Best food, Worst Service. Ying Thai 2 along Lygon St serves one of the best authentic Thai food you can ever find in Melbourne or anywhere else in the world. It was my 3rd time there last night.Waited 30mins for a table, and then 45 mins for the food to come. On top of that, they got an order wrong and refused to admit their mistake. But with unrelenting perseverence, we got the order we asked for, as well as the wrong order which was thrown in free of charge. I like your food very much Ying Thai, but you could do some improve the service quality. I won't be seeing you anytime soon, but the next time I see you, I had better be having the best dinner.

I really hate how medicine has taken away the social life i longed desire to have since coming to Melbourne in 2006. So, I've decided to take the subject Medicine by the balls, and SQUEEZE THE F#$%&*NG HIGH Distinction out of it. Watch out, the JTRain is coming thru.

poor in spirit and in wealth....

2007-03-22T03:24:00.000-07:00

paid danielle for the damaged that I dealt to her suzuki swift a few weeks back. this set me back just over 400 bucks.damn, when something like that happens to your own car, you feel the full force of it. Driving and riding in my parent's Saab back home, it did not occur to me, how much a part of your life a car can be. A minor scratch on the surface, feels exactly like a deep cut into your own flesh. Imagine running a razor blade across your cheek, when you shave. Thats how it feels.

Been feeling really tired the past few days. Coffee no longer exerts its sympathetic effects on me anymore but i still drink it in the hope that the placebo effect still holds true. Couldn't wake up for 8am lecture this morning. So the 2hours of school today, was a rare luxury. Visited the hair salon today to get my hair trimmed, the hair stylist Katie was real fun, and not to mention quite HOT. If only the rest of the australian girls were friendly and nice like hairstylists, life would be just perfect. Not to say that they are hostile or anything, but the majority of them can do better.

They could also work on their general knowledge of the world.

"I'm so surprised you come from Singapore, because you speak English really well and clearly."

Hello!? Please get around and see the world, Singapore's first language happens to be English. Just because my skin isn't white does not necssarily mean, I should't be able to speak English.

white girls, you all may be hot and i like you all but you could do better in the IGNORANCE department.good haircut though, so I shall see you again soon.

diarrhoea day.

2007-03-19T02:18:00.000-07:00

today i had the worst shit of my life.it was never ending, always coming. the harmless rumble, the asphyxiating feeling. finally when i couldnt hold it in anymore, i let it go. it wasn't a pretty sight, and it's memory will not be short lived.for as i type out this blog, the monster inside me os awakening from its slumber yet again. what could i have fed its agony, i do not know. was it yesterdays milk? the week old yoghurt? or the bucket of portabellos?i need some good old hot tea....this ranks about second to the episode of stomach flu i had back when i was 15.

now back to the agenda...

so i have to come up with something known as the 'Learning Agreement' this is for the community placement I am currently doing, and it will outline the lessons I hope to take away from my time spent there, as well as how I would be able to serve the centre, within my abilities.

What I hope to achieve after 12-weeks:

1.Learn the Billings Ovulation Method.
2.Learn the benefits of natural fertility.
3.Improve my inter-personal skills with people.
4.Improve my organisational skills in helping with the seminar.
5.Learn how non-profit organisations are able to work effectively on a tight budget .
6.Learn how to work effectively in a team, with new people I meet for the first time.

How I hope to contribute to the organisation

1.Work that I put in will contribute to a very successful seminar
2.Ideas that I give would help with the donation campaign.
3.Contribute to reinventing the perception of the Billings Method, from its 'old-fashioned' image.
4. Help increase the awareness, help in its promotion efforts.

I have 2 weeks to do that. So i shall keep the creative juices flowing for the moment...and add on to it again later...

Took a 5 min drive to top up the gas in my car, and now the stomach feels alot better.thoroughly enjoy the cool night air, blowing thru when I'm crusing in my ride.
if only gas was cheaper, i'd do that more often. Tonight, its more Cardiac Pharmacology to go through. Peace.

I need a STIFF SHAFT!!!!

2007-03-16T04:50:00.000-07:00

school ended early today, and by early i mean 3pm. Thank goodness for long daylight hours in summer here in Melbourne. To capitalize on that, I headed down to the Glen Waverly Public Golf Course, for a short 9-hole game.

didn't play well today.had a few pretty good drives going between 220-240m, so thats alright for now, but the short game was terrible.Having said that, the greens today were horrible, wet and mushy from the slight drizzle, and overnight rain. Can't understand why my irons havent been performing as of late, slicing the ball even more than when I use my driver.

which brings me to the main point of this blog. The R-flex shaft on my Callaway Big Bertha isnt doing my golf game any justice.I've got a pretty fast swing, and with that the shaft tends to WARP qutie a bit, and the club head does not come into contact with the ball accurately most of the time. To alleviate this, I've been having to down-hold on the grip, shortening it slightly, to minimise the warping. With this, obviously comes the downside of lesser distance given for greater accuracy.

a stiff-flex shaft with a stiff tip would do my swing more justice, and it SURELY will improve my game drastically. something below...would be sweeeet.....

a little bit of spontaneity makes a good day.....

2007-03-14T23:54:00.000-07:00

did a few spontaneous things today. firstly, decided to skip the morning classes adn headed down to Monash Medical Centre, and sneak in on a procedure. The idea of observing an angioplasty was really cool, howevery to my dismay, all i got to observe were 3 angiograms on 3 different old guys. This was a morning well spent nonetheless, being the first time seeing how an angiogram was carried out.

MMC looked quite good contrary to popular belief. The 'oohs' and the 'ahs' reverberate non-stop at the mention of The Alfred, but nothing much about the MMC. I would not mind going to MMC for an entire year, when i start my clinical rotations in 3rd year.

I have this Lebonese woman for a clinical skills tutor, who uses this paternalistic approach to teach students. I bet this is the exact same way she interacts with her patients. Being so rigid with the simplest of procedures and at the same time, being out of date with stethoscope technology. IF SINGLES-SIDED Stethoscopes weren't designed for a cardio-vascular exam, WHY WOULD LITTMAN'S TOP OF THE LINE CARDIO STETHOSCOPE BE SINGLE SIDED!!!!! woman, you are a GP and for goodness sakes don't embarass your self, you are a medical doctor none the less. This is the second time you haven't give me the correct answer to a question, which answer I already know.

3rd STIKE ..and YOU ARE OUUUUUUUUTTTTTT!

Another spontaneous decision today....decided to go down to the driving range to practise my swing. Was hitting better today, though not as good as I would like myself to be. Going to go for another golf game tomorrow, hopefully it all turns out well.

Pretty glad the weekend is here again, school work is piling up and there is so much to catch up on. Just being in the Cath-Lab today, and not having any questions to ask the consultants pretty much shows how much I have yet to cover.

the first tuesday not playing golf....

2007-03-12T23:51:00.000-07:00

so today was the first day of my community placement, which was in Fitzroy North, at the Billings Ovulation and Research Centre. At this place, people who are either wanting to conceive or avoid a pregnancy come to learn how to go about it the 'natural' way.

Now, Billings' idea of Family Planning is totally different from that of contraception. Where contraception, aims to avoid conception at ALL costs with the aid of chemical ( the 'pill') or mechanical intervention, Natural Family planning is about the woman understanding the physiological changes, as a result of the hormonal changes in the body and the way it is expresed physically. With this understanding, the woman is able to 'read' the FERTILE and infertile periods during her menstrual cycle, and thus plan her days of intercourse to coincide with days of Maximum or Minimum fertility. THIS MUST NOT BE CONFUSED WITH THE RHYTHM METHOD. Amazingly enough, the success rate for avoiding pregnancy is 98-99% whilst that for conception is 78%, which is much better that IVF or AI. This also happens to be the no.1 choice of natural family planning in the Baby Booming Capital of the World, China.

Another interesting fact, which I personally have some doubts with. It seems, that if a couple had a good understanding of the Billings Method, and the woman knowing the physiological changes taking place inside her well enough, she can actually plan which day to have intercourse, so as to determine the child's gender, with 95% sucess. Although it's only the first day, it seems like I have another Health Promotion task on my hands already. Nonetheless, the Billing's Method, will be a very useful life skill to have, especially since I will be a doctor in the not so distant future.

So Ladies, in time I shall be more well versed with YOUR BODIES than YOURSELVES. Beware, the Jman is in the midst of revival.

A late start.

2007-03-12T04:40:00.000-07:00

I've just learnt that in this year, I would be forced to embark on a medically irrelevant project and this blog is just to record the mostly mundane but sometimes erratic nature of a medical students lifestyle.

CPP ( Community Project Placement) starts tomorrow, and to the Billings Ovulation Centre I will go. I'm actually quite excited about this weekly activity, from which I will formally become the guru of natural fertility in prevention and promotion.