This is my roll, how about yours?

2011 came and went. i wouldnt say it passed in a snap of fingers. it did feel like a long way. :) but looking down memory lane was fun. ending 3rd year in mid 2011 and reaching mid of 4th year at the end of 2011 makes it a wee bit harder to start 2012 with much new resolutions. but thr're much I am thankful for. :D

working with my best buddies, people in amsa and great family medicine dr.s and presenting our papers in eamsc, fmsc and the public health conf.

experiencing new culture and practices in a 3 week elective posting in Taiwan.

exploring new places with great buddies. from tanjung karang for public health posting, teluk intan, bangkok, the universal studios, spore to jb and segamat, taiwan, kuantan, seremban, borneo highlands and penang. each one an adventure of its own with great memories.

growing spiritually as i try out and take up more responsibilities in the church and life group. experiencing more of God in my ups and downs, trusting in His plans and in Him to deliver me. 

meeting new friends, relatives and acquaintances through amsa, elective posting, conferences and in church.

being exposed to new medical postings and gaining more perspective on medical issues. 

it was fun, maturing and enriching. :) every journey is a learning path.

2012's gonna involve getting through final year - which kinda scares me, but feels pretty enticing as well,

i havent decided what to do in my next 2 month break if i pass peads n ortho, maybe a small trip and volunteering in an NGO. :P 

Year 2012 is the Year of the Holy spirit. 

God is moving churches towards the prophesying movement. and we need to be still and to be sensitive to the promptings of the Holy Spirit. the new year goes into reading more christian books to increase my understanding of the work of God. when one is able to discern the work of the Holy Spirit and put their trust in God to do as He has prompted us, things work out more effectively and bear fruits. :) I want to grow in this area.

Happy 2012!

Ending 2011!

Wonderful week with holiday frostings on the sides. :P had a greaaaaat! Christmas wkend after ending the peadiatrics exam and simply looking fwd to this long wkend again after the 1st week of orthopedics. *beams*

to date i've thought of some new year resolutions. 1 of which was inspired by Carmen when we were just talking about doctors and specialists in hospitals. i've always had a problem of inferiority complex when i'm in the hospital. 

- it starts in 3rd year when u enter the hospital and ppl tell u that as a 3rd year medical student, ur position in the hierachy is equivalent to 1 being in a bottomless pit and you have no worth that microorganisms surpass u. lol. they tell u that no1 cares about u, u block the way in ward rounds, u ask stupid questions etc. u get the idea. 

- n there's always a fear of offending some1 important (by important the definition varies) and having urself being blackmailed / fail in exams or being kicked out of medical school bcz its simply so easy to do that. as in, bcz medical knowledge is so vast, u can be asked simply anything under the sun in exams and if the examiner wants to fail you, its so easy to find reasons to do so. 

- and bcz it's impossible to study everything and unfortunately i don't really have good retention of knowledge, i feel really inferior to senior dr.s who shoot questions at me and i can't answer and generally i feel really dumb. 

so... yeah. omg this has turned into a rant. i'll keep in short.

in short, a way to keep ur self esteem leveled and to not be talked down to is, to talk to ppl at the same level in the first place. if u talk up to ppl, they sense u feel inferior, and they tend to talk down to you. making u feel even more inferior. 

conclusion: Talk at the same level to ur superiors. 

i tried it out. and boy, does it work. not to the extent that i suddenly magically command respect from superiors xD but it helps me stay confident. and i have less fear. having confidence is sth really important to stay sane and happy in medical school. and perhaps later in life and in any other fields of course. *beams* thanks Carmen. 

so that was new year resolution no.1. :D to stay confident. 

new year resolution no.2 goes into spending more time to develop myself spiritually. 

no.3 goes into no i gave up on the 'i will lose weight' resolution cz it never works. xD

so no.3 goes into hmm ok i'm stumped. this shall come later. :P

awesome Christmas weekend with my church youth. recently we just launched our new NGO, called My3K (no not at all linked to 1Malaysia or any gov propaganda hehe). the NGO works on giving free public health screening - esp to rural areas, mobile clinic style in collaboration with the National Kidney Foundation & National Glaucoma Society and to be a medium for the depressed/single mothers/pregnant teenagers to obtain help. so here we are in our centre in Setapak. :) a group photo of the volunteers after the health screening.

organised a Christmas party with Alain, Mei Mei, Alisa and Siaw Khing.

and got to meet up with Cher! :D

orthopedics has been pretty interesting. i dreaded the thought of bones and metal stuffs at 1st but its more interesting than i thought. hehe! tho there's the constant dread of having to wake up in the wee hours of the morning (groans....) to cover beds for ward rounds..

ward rounds can be an interesting time for observation. among our topics of discussion (betwn just the medical students la xD): who's better looking? ; did that dr. wear the same shirt as yesterday?; my gawsh all these dr.s are so HUGE (tall / huge biceps / strong looking) - in between the proper discussion which goes on among the dr.s. heeh.

another long wkend! yay! orthopedic surgeons are generally very nice and easy going. the only part is their high probability of postponing or cancelling classes with u last minute when they get whisked off to emergency operations.. which is of course no1's fault but bcz of the surgeon's commitment to his job n the patients. strike 3 in just today itself: 1 lcd projector refused to work in a 7.15am class, and 2 other surgeons cancelled class after a 1 hour wait. sobs. 

ok. enough ranting. :D all the best in coming up with awesome new year resolutions!

Merry Christmas!

short case over, the Christmas mood is up! nola actually my christmas mood was on the moment the sales and shopping started :P no short case is gonna ruin my christmas wkend. it was pretty traumatising that when i lay in bed last night it started coming back to me. everyone's got their 1st (traumatising short case) i suppose and it's my turn now. sigh.

aaaanyhooo, got a number of errands to run b4 starting class next wk. hav2 get the hp serviced (yeah the bluetooth and wireless went dead -i dunno why, i dont rmb dropping my phone (that badly)?) but at last thr's still a waranty. got2 get a memory card for my camera. lost it since last hols and couldnt take any pictures since. :S and gotta get a number of academics stuff settled.

minus the activities keeping ppl up and about this whole wkend, it's nice to wake up at your own pace to a nice sunny morning and just totally go online bcz that's what life is about. kidding :P but yeah what else do u do in ur room once u wake up other than going online for entertainment. for me at least. surfing and listening to random christmas songs for now :)

this is simply heart warming :)


i explored The Piano Guys a bit, and being a biiiiiiiitttt of a star wars geek, i found this vid, kinda wacky :P


have not thought about my 2012 resolutions. hmmm..... have a week to think.

so when u wish others Merry Christmas, what does it really mean? i was pondering upon that for a brief moment. then i concluded that it simply means, have a week filled with love, joy and peace brought by Christ into the world. *sigh of contentment* b4 u step back into the reality of exams, work, stress, let's just sit back relax and enjoy a wkend of escapade with our loved ones. :)

Merry Christmas!

Sanctuary

7 weeks in Peadiatrics posting, and i think i caught the gist of childcare and overcame the awkwardness of facing children. gist though i said, not the whole package. but a whiff that's substantial enough to bring back home from the wards. 

           

seeing children with chronic diseases makes you appreciate what you had in your childhood. and u kind of get the idea of what your parents had to go through raising u up (to ur twenties). man. *wipes sweat.

there were children w thalassaemia who had to go the hospital every month to get blood transfusion.

children who stayed in the wards for weeks for serious lung disease.

mothers taking care of their children with cerebral palsy- they grow to normal adult sizes but can't talk/walk/self care so they're wheelchair/bed bound.

parents with syndromic children.

parents with special children. seeing all these cases opens your eyes.

in the management of ill children, a huge bulk of it is in managing the parents emotionally, psychologically, socially. u got to really talk to the parents. understand their background, education level, occupation, financial limitations, how many other children they have, can they cope with bringing their child to the hospital every month, are they able to give enough attention to the sick child, do they have good family support.

i encountered a mother with 4 children with bronchial asthma: has 8 inhalers in the house. and she's got 2 make sure all her children take the inhaler puffs everyday twice a day. (i'd have gone bonkers if i had more than 5 inhalers ard my house)

a mother resigned from her job and committed herself to go to school and change diapers for her child everyday during his recess time. he has spina bifida (paralysed waist down including bladder control). other than physical needs, she's gotta deal with the child's emotional needs. bcz other than the paralysis, his IQ is normal. he's like any other children, who have peer pressure, the fear of being an outcast, self esteem issues etc. imagine urself to be the only person in the school wheelchair bound, and ur mother comes to change ur diapers for u everyday. it can be humiliating for him. and its not easy for the mother. but she's his motivator and stronghold. bcz she knows the moment she gives up, he gives up on himself. she's 1 strong woman. *salute

i imagine how mothers/fathers in the hospital feel when they see other babies around them growing and developing normally, talking, crawling while their 1 year old child looks different, doesnt talk, doesnt respond to them bcz she's syndromic. of course they love their child. but its not easy.

the emotional and psychological aspects are strong hard huge parts. and dr.s need to know how to handle and address them. it's all pretty overwhelming. i am moved whenever i see mothers taking care of their child with cerebral palsy. at least when we see how much the mother cares for the child, we know the child is in good hands.

the other side in peads: 

            

newborns. cutesie adorable newborns. they suckle at reflex when u put anything into their mouth. teehee. 

the art of coaxing babies? maybe just 60% there atm. kids love squeaky balls. babies love rattles. but if any1 starts crying, quickly give them back to their parents and runnn! unless u're in an exam. then u're trapped. xP 

having a short case next wk. keeping fingers crossed for a happy wont-cry baby. 

this is a rant

it's one of those times that you don't particularly have anything to write about, u thought u might wana write about sth, but decided nvm. tmr marks the start of my 2nd semester. i couldnt help but wake up today with a gripping fear of the thought of starting Peadiatrics posting for the next 8 wks after hearing countless horror stories and dying sighs and laments from fellow coursemates who have gone through it in the last semester. then again, it is pretty exciting to start a new posting, this 1 dealing with children in particular. i've never been really good with kids, i mean, i think they're cute and fun to play with, but there's stil a kinda sense of awkwardness when i approach them. like, umm, hi...! (awkward smile no? grin no? umm play with me no?) what shud i do...??! err... yeah. u get what i mean. but aaaanyway, let's not lament further about something i havent even stepped into. i should give myself a chance. heh.

the past week was a real holiday :) went to penang, had a great time eating all those penang food i've been missing for the past 5 years. no regrets :P visited my uncle there and stayed on penang hill for a night at his place. awesome escapade..

managed to lost my phone again this year, this time in the operating theatre changing room. last year it was in the maternal delivery room. the heartbreak healed eventually. goodbye Nokia 2690. truly faithful and hardy. thank God for the spare Nokia 1203 i had for my ex-number ok that was wrong i meant my old hp number which has expired. survived with it for the last 3 wks or so. n finally got myself a Samsung galaxy mini this hols. its a shame i couldnt find a phone with both touch screen plus keypad at a kiam siap price with wifi access and android. lol such demands. anw its pretty ok i guess. rm499 from a samsung booth at sg. wang. ok who wants to know what phone i'm using i am seriously ranting unnecessarily now.

and... yeah i successfully created a rant to post. goodbye... holidays, hello... peads!

Wkend of much worth

this weekend of sorts has been most fulfilling.
after finishing my mini clinical exam in the eye clinic, we set off to meet some of our seniors who were most dear to us who have just graduated. it was pretty fun seeing them throw their graduation hats and all. :P nice to catch up a bit but we didnt stay long.

went to the VC cup tournament in Bangi which was being held for the 1st years. it had been really long since i set foot in debate training or any meet up, 1 whole year to be exact. i have to thank kevin, john and prethivan for asking me to go to this tournament. i previously felt it would be awkward for me to reappear, but it wasnt like that. in fact, it was rather warm. and i had a good time meeting debate friends whom i have not met for such a long time. i'd missed them. a lot. the non sensical jokes, chatter, rounds of group board games and sharing life with one another, the intensity of debates requiring one to think quick, analyse and have adequate common sense and general knowledge. the positive stress and adrenaline rush wasnt in the picture this time round though because we were just there as adjudicators. the 1st years were the ones going through the real stress. :P it was really pleasant to adjudicate rounds, give structured oral adjudication and feedback on debate rounds with the 1st years. i had nearly forgotten how it was like being a debater. this experience of course doesnt sum everything up, it was just a little taste of it that flooded back warm memories and gave me some self worth or so called morale boost i thought i had lost in my ability to provide input in the club. anw, i had a really enjoyable time and i'm proud of the 2nd year trainers (and huge gratitude to dinosaurs too of course) and the 1st years who made it through the tournament. Yay to KTSN winning the VC Cup this year. :D cheers! the heart still has a special spot for ktsn, the place i grew the most. =)

in the midst of the hype of graduations and debate, a precious life was lost. heard the news of a student who took his own life by jumping from a hospital building in his hometown few days ago. it was a manifestation of a chronic psychiatric disorder. he had debated in last year's vc cup and had joined my church shortly last year. for those who knew him, do pray for his family members that they may have peace and rest in the grieve of losing their son.

had a warm fellowship with my life group members.
had a pleasant early birthday song surprise from the debaters. and a card of indescribable awesomeness. :D
had an impactful sunday service.
got an adorable sheep.

looking forward to anaesthetics posting tmr. canulla setting challenge ahead! :P

Merdeka

It was just a few days ago that I rmbed saying 'Owh! I didnt realise National Day's next week!' nah. just another day. most of us probably lost the sense of excitement for National Day since our primary sch days (for me at least). in primary sch, it was the excitement of having a school holiday, switching on and sitting in front of the tv the entire morning, watching as the prime minister and DYMM YDP Agong arrive, seeing the grandiosity of the whole occasion with smartly dressed troops standing in attention, etc.. and my favourite part: the parade and the coloured smoke jets :D

well now, the excitement has definitely diminished if not disappeared. the celebration is seen as a superficial cover over many many issues thrown ard in the political scene, and most ppl dont feel the pride of freedom from foreign rule our leaders achieved 54 years ago anymore.

my church had a Merdeka special service yesterday morning. this video was being shown. i guess videos have a way of illustrating and bringing u back to the moment in time, thousands of times better than pictures or words alone. If you have not clicked on the video to watch it, watch it first. :)

as i sat watching the documentary, still in black and white, seeing the stadium bursting with Malaysians of all races, seeing the Union Jack being brought down, Tunku Abdul Rahman leading the multitude of ppl declaring 'Merdeka!' echoed by thousands and thousands of proud, united Malaysians, i felt a pang of pride. mixed with a little guilt for taking many things for granted in this country. You could just imagine yourself being one of them dressing ur best and marching off to the stadium that morning with a whole throng of ppl u probably didnt know, but as u walked along, u smiled at each other because deep down, u shared sth in common.

As I stood up to sing the National Anthem, I wondered, when was the last time I stood up to sing the National Anthem with all my heart.

This might seem naive and idealistic to some of you, but deep down, you know that you're a proud Malaysian, and there is no other place in the world besides here, that you can truly call home.

It's time we count our blessings and pray for this country. :)

Lessons

i learnt two important lessons today.

1. you might think that the person you dislike is the worst, most egoistic, sexist, most horrible person you have met ever. but that person ends up teaching you something important.

speaking from a very very recent experience. i disliked certain authorities. to the point i had to stop myself from rolling my eyes every time i had a glimpse of the person. i thought he was evil, arrogant, annoying, well you get my point. but his nature of putting excessive sarcasm and mental torture into his speech made me learn something that was pretty important today that i think i will remember for the rest of my life. lol. i still do not really like him now, but the level of resentment has dived far down.

so think about it. your foes make you a better person. deep down, i know that a reason i dislike him is also my own problem of self ego. heheh. :P

2. a friend quoted her dad's words to me. And this is what he said.

"If someone brags about himself to you, he has all the right to do so because in fact, he IS better than you."

Many ppl might disagree. but when you think about it, it's true. and the only way you can make the other person stop bragging is to work harder and become better than him.

It's a form of motivation. even though not in the nicest way. hehe.

So.... don't hate your enemies. love them for how they build you up and make you a better person. :)

1 week of Raya holidays coming! Selamat Hari Raya to my Muslim friends! and as the holidays start, The Mugging Returns.. i am going to miss ent posting very much. Have never met so many awesome friendly amazing teachers of doctors. :D

Stressed. Very Much.

Stressed. It is an understatement.

The mind filled with it.

The air reeking with it.

The timetable staring back at me screams of it.

Adrenaline pumping because of it. Reserves emptying fast.

If I were at the seaside I would love to give a good loud scream to let it all out and not have people around me thinking I was mad.

Oh God help me.

as series of tales unfold

the reason people indulge so much in tv shows, esp tv series is because it brings them into a world of unreality. it takes them from reality, aka their problems, work, decisions, and let them put their hope into sth that has an ending as the tales unfold series after series. no one likes to watch the Last episode of the season because it leaves you with a question mark, an unfinished end, Or, it brings you back to life, hits you in the face saying, now get back to reality. face that mount of assignment you need to finish, the monday blues at work every week, the tense relationship you have with that colleague, the harrowing deadlines and demands that need to be fulfilled. a parallel to a syndrome faced by many at the end of a long holiday. fun under the sun replaced with the furl of the world.

oh no maybe its not everyone. just those who get addicted to tv series and when you finish that last episode you get a horrible withdrawal. but you got to admit that everyone needs their share and dose of daydreams and charming fantasies in wonderland at times. not to the point of literally living in it and developing delusions of course.

how do you soften the bump when one lands from a high leap from dreamworld back onto soil? the impulse tells us to watch another set of tv series. the leveled head tells us to open the books and start prepping for what is to come. guilt sets in. fear builds in. the worker takes a hesitant step towards the tractor. the step multiplies. momentum sets in. shuffles turn into strides. the tractor starts running. as soil is churned, seeds are sown, plants watered, flowers bloom, it hits. reality in itself is and can be beautiful too. uh... uh.... put those tv series away....

i wonder if the above made sense to anyone.

Awe

Who would

Spend the entire night trimming coconut tree leaves with a knife to get the middle portion we call 'Lidi' for my boat house model art project in form2.

Search shops for double layered crepe paper and puppet eyes for my doll art project.

For my rocket project in form4, cruise around town looking for shops selling bicycle pump needles cz i kept breaking each of them, buy a brand new silicon gun and a huge bottle of silicon from the hardware store, find tons of plastic bottles for me to trial and error, drive to the nearby park early in the morning with a tank of water and metal measuring tape to test run the plastic water rocket.

Scour bushes, trees, grass, any area with plants u name it for locusts / bugs for my form6 biology project / lab work.

Drive all the way to the bookstore to photocopy a few pages of pictures i needed for class the next day js bcz i was last minute in primary sch.

Spend the entire day scouring through Airline magazines for pictures of leaves and plants cz i needed super a lot of them for my artwork collage in pri4. (thr wasnt Google back then)

Drive and accompany me to the Tugu Pahlawan (the 1 in kch at the museum park) to take like just 5 photos and to the museum to look for catalogues on Fort Margheritta for my history project in form1.

Pack lunch and drive all the way to school when i had around the clock band practice. Wait in the car in agony when practices end late.

Search like crazy for a particular caterpillar stuffed toy i crazily wanted in malls when i was a kid cz at that time the tv was advertising them like no1's business. (Blame the tv)

Walk to the nearby discount store and back to surprise me with a stuffed toy i wanted so badly that i went ballistic (lol) even tho it costed quite a bomb. okay i was in pri4 that time n i still have that stuffed toy til today.

Patiently teach me to ride a bicycle by taking the trouble to make me a 3-wheel bicycle by removing 1 trainer wheel so that i had a backup trainer wheel lol.

Buy me princessy dresses in kindergarten.

Rush me to the hospital for stitches when i swung on the clothes line support bar like a monkey, flew and hit my chin on the ground in pri3.

my gosh even reading this is tiring.

I wouldn't have been able to do all that for a single person.

But mum and dad did.

Wow. realise i was quite a ma fan kid.. sheepish grin.

the brass band

as if i wasnt torn enough, blogspot had to erase my entire blog post about me emo-ing about missing the finals of the world marching band competition which was just 500m away from me in a stadium opposite the hospital where i'm staying. it was going on every night for the entire week but i didnt know. sobs. :S

to cut the whole illustration short, it brought back reminiscence from the past. days of playing in the symphonic brass band back in secondary sch. the tingling sensation, the little shock waves that run through your body as you play in sync, instruments coming together to create rhythm, tunes, music, life. the majesty of a fanfare, the serenity of a sentimental tune, the upbeat pop song, things that just make u wana tap ur feet, nod ur head, sway or sing in ur heart (since u cant sing out loud with a mouthpiece at your lips :P) the wave of the conductress' baton (Laura!) , the drum roll that commands instrument up, the adrenaline surge as the song reaches its climax or as all instruments blast in the finale.

awesome feeling. :D

hope to be able to catch next year's one then. *Hopeful*

end of posting

Had my last class in Psychiatry today. Had a pleasant surprise :D

Got an adorable funny bunny bookmark from Dr Hazli for answering a question non-really-but-close-to-correctly. XD

For some weird reason I felt inclined to say Meow when looking at its adorable face.

For another weird reason the bunny doesn't have a tail.

?

Had an interesting 8 weeks in Psychiatry with Prof Hamid. All psychiatrists are super nice, patient, pleasant and did i mention, nice? grins.

It's the end of posting! Heading back to Kuching on sunday night. for a week.

After that Hello Ear Nose Throat, Eyes, Anesthetics! :D

Eww Working Emails?

rmb the last time you threw your hands into the air in frustration bcz ppl didnt respond to your panicky emergency email requiring them to complete a task?

or the time you felt ppl were irresponsible or incompetent for not doing things the way you expected them to?

or felt like you could have done a job like 100 times better than a person?

or had pent up feelings of anger or frustration or resentment towards some1 (worst still if that person was your close friend) bcz of certain habits you couldn't put up with any longer?

So you're thinking, What in the world is wrong with these ppl??? (while trying not to pull out the remaining hairs left on your head)

What do all these things have in common?

Lack of communication.

Whose fault isit?

Both parties, but particularly yours bcz for all you know (and you know very well), the other person has no idea that you felt that way. If they did, it's human nature to not address it if you don't mention anything cz ev1 wants to avoid a confrontation.

I some-sort had a realization today.

In the past, when I organized a programme, I used to send out work emails bcz I thought I saved ev1's time by having less meetings. If I had meetings, I kept them short and straight to the point.

problem was: Hardly any1 responded to those emails / got things done by the due date. I was wondering why was it so hard for ppl to check emails / reply with a 'Noted' that only takes up like less than 10 secs of their life when they can update their Facebook statuses daily.

I thought ppl were being irresponsible and hence I resorted to writing work emails in a menacing way. (at least what I thought sounded scary enough to make ppl reply or start work).

But obviously bcz ppl can choose not to respond cz you're not staring at them face to face, it didn't really work either.

The only solution: Long meetings that require going through the most detailed of details to make sure things turn out properly. Sounds real horrible and life threatening.

Now being on the other end, with me being the one receiving the work email from some1, I now come to understand how other ppl felt when I sent them lengthy work emails.

1. It was hard to maintain attention span esp reading through details of what I was supposed to do.

2. It was harder to rmb the sequence of events (of a programme)- written down. as opposed to it being explained to u verbally.

3. It was also tough rmbering what other ppl were in charge of, esp if the list is super long.

4. It was easy to get distracted by Facebook and other more fun things.

5. When work emails demand for a feedback, it was easier to ignore the email than to squeeze out brain juice to think of a feedback or ways of improvement and reply.

and my feedback to the person sending the work email would be to:

- Have a meeting to brief everyone face to face.

- Get feedbacks face to face when ev1 is forced to think on that spot.

- Unless you really trust the person to be able to read ur mind and know what you want, go through details together with him/her. Details details details.

I admit that in the past the way I sent work emails were neither efficient nor productive. esp when the group is large or when you do not know your members well enough.

If I have ever caused any1 much pain due to the way I worked, much apologies. :P

Still.... working on improving communication. afterall, every1's still learning as they grow.

Tho of course work emails + minimal meetings are extremely effective when you know that every single person in the group (usually a small group) is really responsive, responsible and committed to what they're doing. :)

And in some particular experiences it is true that certain group members simply do not care and are inherently and impossibly irresponsible. so comes the art of getting them to get things done on time. tho frustrating, maybe it trains us to develop creativity and tolerance to the last straw. >8P

Now that only talks about working in a group.

About internalized negativity towards ur close friend(s), it's another story.

Nonetheless, the keyword is communication.

We all struggle in this area, one time of another, regardless of how good of a speaker (we think) we are or how good our EQ is.

So pray for courage. And words of wisdom. :)

Yay. The End.

=(

I.just.realised.that.I.caused.all.the.photos.on.my.blog.to.be.deleted.

when i deleted the photo album that housed all my blog photos on Google Plus few wks back, thinking I didnt want a log of photos on my Google Plus account.

the mystery of all disappearing photos on my blog is solved.

but I AM EXTREMELY FLABBERGASTED.

i dunno if I should just blame myself for not realising that would happen.

or

blame Google Plus for not giving a clearer word of caution. (maybe they did but i didnt realise??)

all my previous posts' photos gone. gone. gone down the drain....

where else but to lament about it here?

*heartbroken* :(.... even that is an understatement. :(....

The Unspoken

Language. By far the most essential tool for communication, to express thoughts, get what you need, get what you want, spread love, care, peace , provoke, poke fun, create parodies, in short, sth we cant do without.

the main ingredient needed in that recipe of communication is:

Being able to understand each other.

Not the deep understanding of feelings and all, but basically just simply understanding what the other person is saying.

In other words, i just had a language barrier crisis this morning.

Felt extremely helpless talking (if you call that talking) to an elderly Chinese lady who could only speak Cantonese (the full blown fluent Cantonese). she could understand a bit of Mandarin thank goodness. She was in the psychiatric ward on a wheelchair and i wanted to talk to her to ask her how she was doing, what brought her there, if she was ok. and basically to just be an ear for her in case she was lonely.

the outcome:

i solemnly vow to BUCK UP MY FREAKING CANTONESE AND HOKKIEN!!

poor aunty was lamenting her concerns and worries (i think) and all i could do was to nod my head, smile, show concerned and emphatic looks and make agreeing sounds (Mmm) and ask her about herself in mandarin in when i thought were the appropriate times.

ARGH! i could just slap myself for not actively learning up those dialects in my whole previous clinical year.

it's still not too late i guess.

Plans:

1. Force my friends to speak cantonese to me.

2. Download important cantonese and hokkien phrases from the net.

Anymore ideas? :P

to or not to

life's made of massive decision making. every single thing you do results from signals that course through your cortex. will there be a time when u get tired of thinking, and all you do is to stare into space and make yourself think you're not thinking. but there you are. that's also thinking. ok what in the world am i thinking now.

some decisions are too large, too hard to make or just plain vague and we can choose to:

1. take that radical step to make a decision after we have analysed things through.

2. continue to be in denial and 'see how things go'.

3. get another person to make the decision for you. (this usually never works lol)

datelines prompt us to (finally) make our decision.

so if there're no datelines... how now brown cow?

you're disturbed by the thought itself.

you do other things to distract urself from it, but it comes back to you over and over again.

annoying really, because of its chronic course.

you're unsure of things.

should i? should i not?

ahhh forget it. 'see how things go'

but that annoying thought still lingers.

maybe there'll come a point when we can take it no longer and we'll be forced to decide. and we'll close our eyes, trust our instincts and muster all courage to move on.

why in the world did i just write that? what was i thinking? ?

silence

we can't speak but we know we share a sense of togetherness. we can't write but it's definitely stirring deep down in our hearts. how long can physical barriers hold. a dam can only hold that much water. when the pressure is too much there will be cracks and it'll finally burst. surely they know. is it their denial that continues to garner such actions. I can only pray.

Overcoming Addiction

i didn't mean for this blog to be filled with so much healthcare related stuff, but it seems like most of my inspirations / ideas to write come from there. pardon me. :)

i had an attachment at the Methadone Clinic this morning. it's a clinic where people with problems in drug addiction voluntarily come and seek treatment. They are assessed by a doctor and prescribed with Methadone, which is a drug that is chemically similar to Opioids (eg. Heroin, Morphine) but harmless. (relatively) it helps them combat the withdrawal symptoms of not taking say Heroin anymore and slowly wean off the addiction.

now when u think 'Drug Addicts' what comes to ur mind would be (well for most of us at least) shabby unkempt looking immoral hopeless criminals who in no way should be associated to us. in a less harsh way, it's pretty hard to be compassionate for this group of ppl.

do they deserve to be shunned by society?

can they control their addiction if they had immense will power?

who asked them to start taking drugs in the 1st place anw? it's their problem. is it?

Drug addicts caught by the police used to be thrown into cells and left 'cold turkey'. meaning, left to suffer the effects of drug withdrawal such as bodily pain, feeling as if a thousand needles were poking through ur body, u can roll around in agony take off all ur clothes and u would still feel that intense burning pricking pain that wont go away for all mercy. there would be secretions flowing out from ur nose and ur eyes tear non stop. u feel like u have no ounce of energy left in ur body to move. in more severe cases, they start vomiting and have diarrhea and start shaking.

I used to picture all these in fear, feeling slightly sorry for them but not really feeling much empathy.

There is another perspective to this.

Drug addiction is a disease. An illness, that requires treatment. Just as how ppl brought obesity to themselves by overeating and lacking exercise, or bringing lung cancer onto themselves by smoking cigarettes out of their fingers, drug addicts were thrown into this desperate abysmal, unable to climb out due to a wrong step in their past. perhaps due to immaturity / curiosity / lack of moral judgement / multifactorial stress etc.

In other words, leaving people with drug addiction problems to die with this problem / refusing to help them is inhumane.

To expect them to completely put a halt to this drug abuse would be like asking yourself not to sleep for 3 days. ok poor illustration. lol. but u get what i mean. the drugs affect a person's mental condition. and unfortunately ur mind is what controls ur body. so when ur mind goes haywire, so does ur body and its a whole vicious cycle.

The Methadone replacement therapy helps them to overcome the addiction. But not entirely so they still have to have self discipline and want to help themselves overcome it in order for it to work. The dose is slowly tapered off, however, it takes years for a person to completely overcome the addiction. They visit the clinic daily for a dose of methadone, a pink liquid that they gulp down in front of the pharmacist. those who're more stable are allowed to take home let's say 2 or 3 days of supply.

now this was a new aspect of humanity to me. i always thought of methadone clinics being a programme. not so afterall. it's a treatment. there's a difference if u get what i mean.

the downside though is that Methadone only helps Opioid addiction. for other drugs like Amphetamine, Benzodiazepine, Cocaine, Cannabis etc, there isnt yet a solution. in future perhaps hopefully. :)

it's a social phenomenon. we dont want it but it exists. and its rampant. prevention and cure needs to come hand in hand. and the best way to treat it is in a humane way.

nothing in particular

its... one of those wkends whr u get really idle and the internet line is really slow and u wonder how ppl in the past managed to get through days without the internet.

now try imagining life without this almighty entertainment information networking provider (to me).

1. Hackers would be out of jobs and probably working on sth that might actually benefit the world.

like making the world's largest strawberry cake.

2. Your stamp album collection continues to grow with snail mail.

3. Your weekends would be filled with outdoor activities instead of talking and laughing in front of a screen and checking your facebook news feed every 5 mins.

4. He/She would have a hard time finding out if she/he's single or attached.

5. Less chances to spread hate mail and defame someone.

6. The Nyan Cat, the annoying orange and Rebecca Black would never really be famous.

7. University students would have to spend their life in the library to get an assignment done.

8. I might just get a pet.

kidding.

9. Phone bills would either rocket sky high or phone calls become free because they become a mega huge life necessity.

10. I would be exercising for fun.

nah. boring.

:D

Now the above are just random thoughts, some merely exaggeration, obviously not done with proper prior research and just my way of spending 15 mins on a saturday evening for self entertainment. apologies for lack of substance and analysis.

the internet line in my campus is horriblyyyyyy slowwwwwww.................. (every page needs to be refreshed 3 times to get the whole thing to load)

i cant wait to go siew pao hunting in seremban :D audrey teo ju yeng tan ek guan norfaidhi akram shalisha jaelyn hehehehehe ok xuvin shaddap.

How far would you go.

this week's clinic touched me emotionally. i'll keep it short.

at the child and adolescent psychiatry clinic,

- thr was a case whr distraught parents came in with their 9 year old daughter who was really adorable, friendly, happy but unable to talk / read / recognize alphabets, communicating only by making certain audible sounds and hand gestures. they had flown in all the way from Brunei for a 2nd opinion, with some hope, for a diagnosis and some form of treatment. they left knowing that their child might just never ever be able to talk. bcz the success of speech therapy esp at such a late age is subjective.

- parents coming in with both children having autism and both parents suffering from depression due to financial problems and being unable to cope with taking care of their children. thr were many other cases with children suffering from depression and mental retardation, attention deficit disorder etc.

i tried imagining hw life would be like if i was the parent.

i was awed and touched by the love they displayed for their child.

in the adult psychiatry clinic, i watched elderly parents bringing in their sick adult child with schizophrenia / depression / bipolar, stories of aggression at home, the child screaming at the parents to get out of the house, suicidal tendencies, caused by noncompliance to treatment. the elderly parent kept reassuring his son it'll be alright, we're with you, we'll always be with you, dont worry.

it was really something. imagine one of your family members suffering from a mental illness. it takes a lot of love to commit yourself to care for them for a lifetime. bcz these sort of illnesses usually relapse and are chronic. they cant be 100% cured with medication. and lots of patients are not compliant to medication bcz of their side effects like drowsiness, abdominal upset, insomnia etc. some of them also cause addiction.

this kind of love is really amazing.

Cause of Death was?

today's class opened up another window for thought.

Medico-legalism. in the world of Forensics.

Ensuring you're protected.

Affording yourself protection.

(just a word of caution that the word dead and death will be mentioned numerously in this post. hope it doesnt cause uneasiness)

Doing an autopsy as a forensic specialist doesnt start with dissecting a patient - a body i mean. saying a patient sounds like he/she's alive.- and using all your years of expertise to analyse the cause of death and injuries on / in the body and then writing the autopsy report. This part, would be what most of us think as the most important part or the part that matters most. Determining / Confirming the cause of death.

Nope. Not really as I thought.

It starts with:

the Dr. in charge correctly identifying the person to be dead.

so i thought: ok that should be easy.

and then the Dr. asked: So, tell me, how do you know a person is realllllyyy dead?

*hmmmm.... awkward silence..

Answer:

There're 7 criterias that confirms a person to be dead:

1. No body movement

2. No respiration

3. No pulse / heart beat

4. Pupils fixed and dilated

5. Fragmentation of column of blood in retinal vessels

6. Primary flaccidity of limbs

7. ECG flat for more than 5 minutes continuously.

Misjudging the death of a person can bring a Dr. to face lawsuit. even pronouncing a person to be dead at the wrong time can bring you to court.

(most of us would think, sure, if a Dr. wrongly pronounced some1 who's still alive as being dead, that would be a really grave mistake that acceptably warrants a court case)

i do agree with that. but there're more technical things that we can worry about as well.

there was a case whr the Dr. clinically judged (without ECG) that a person was dead before arriving at the Hospital (as in he was dead already at the crime scene before being brought to the Hospital). the Dr. did, upon the arrival of the victim at the hospital, confirm his death with the ECG (showing the flat line).

later in court, the Dr. was bombarded by defense lawyers (of the suspected murderer) who tried to make the Dr. look incompetent for saying that he thought the person was dead before reaching the hospital.

with the reason that he couldnt be 100% sure of that (whether the victim was dead before reaching, or upon reaching the hospital) cz his clinical judgement cannot beat that of an ECG machine.

yups...

ok maybe that was quite confusing.

but conclusion is: be especially careful if u're facing a homicidal case. only officially confirm death when the ECG machine is there.

standard protocol when pronouncing death.

1. check that patient has fulfilled the 7 criterias. report as 'clinical death'.

2. reconfirm the death 1 hour later. then only register the death with time of death being the time 1 hour earlier.

before this bores u to the bones, thr's more. :P

Before performing the autopsy:

1. Ensure the police officer bringing in the body, the relative / next of kin of the body (is there for identification purpose and consent for autopsy) and yourself are there beside the body.

2. snap a photo where all can be seen clearly.

(to protect urself from false claims by the relative that he was not aware or explained to about the autopsy. relatives have tried suing Dr.s, accusing them of performing autopsy without their knowledge)

3. snap a photo of the next of kin looking with opened eyes at the body.

(eyes cannot even be closed in the photo cz in court they can say they were in too much stress to correctly identify the body and u as the Dr. who's not in apparent stress at that moment is at fault) - in cases of suing the Dr. for wrong identification of body.

now i think i just made the 'relative' sound like unethical ppl who would do anything to swindle ur $$ by suing you in court at any opportunity. no offense. not my intention at all.

but things like that have happened before. (innocent Dr.s performing autopsy, forgetting a protocol, ending up in court and swindled from their life savings) and can / is likely to happen in today's society where things do get screwed up, ill moral is everywhr and $$ matters a lot to most of us.

putting legal issues aside, i'd say that the forensic lectures did feel a little like watching the Professor analyse dead bodies CSI style.

wow. quite awed. but quite grossed out as well. lol >8P

wasnt mentally prepared to see images of mangled / strangled / suicidal remains esp right b4 dinner.

ok. that aside as well, it's been a pretty good week. 1st week in psychiatry has been relatively relaxing cz no assignments/presentations/case write ups due yet. missed home and taiwan so much last monday but the feeling has somewhat diminished. thank goodness. hav a great wkend ev1! :)

some photos: my housemates in our 4-person sharing unit in the taiwan hospital hostel (min jie, pei sun, wendy)

a group photo in front of the administrative office. the white coats for medical students are this length. residents@registrars wear slightly longer 1s, and specialists wear knee-length white coats like our med students ones back in Msia.

come to think of it, thats a pretty good way to differentiate ranks which can be really confusing for patients. hehe. sometimes patients wonder how come 10 different Dr.s visited them in 1 morning when in actual case 9 of them were medical students. heheh.

Rants

i'm in a mess. i'm not sure if i should emo about

1. missing taiwan- the friends, the serenity, the people, the shopping, my cousin and his wife penny, the hospital, the friendly dr.s and staff

2. starting the term tmr - tho i'm quite excited about starting psychiatry cz its an entirely different posting and quite interesting. just that missing taiwan kinda kill joyed the excitement of starting this new posting.

3. the absurdness of msian issues - the Obedient Wives Club promoting sex classes to enable women to 'serve' their husbands better. it's so absurd i just do not have the energy to comment on it. i don't know where to even start criticizing the way they execute measures to highlight the principle they stand on. like it wasnt bad enough, they had to bring in 1st class prostitutes as a comparison. any educated person would know that you didn't have to go to the extent to bring up prostitution to make your point. so why draw prostitution into the picture. as a mere gimmick to illustrate women as sex objects? ridiculous. all drama.

4. unpacking my luggage and cleaning up my room - dont we all resent this part. heh.

5. missing home. i wish i had another week of holidays to go back to kuching.

that's bout it. i still cant decide which one of these 5 things are most worthy to emo about lol. but by hook by crook i gotta finish unpacking real soon if i wana get some proper sleep tonight. yargh.

last few thoughts in Taiwan

i reached the official end of my 3 week elective posting in the Tzu Chi Hospital and left with a pang of sadness. heh. i'll miss that place. particularly bcz the surgeon i attached with in this last week was most kind, patient and really fatherly. he specializes in Breast and Endocrine Surgery and has taught me a lot about reading sonograms and mammograms in clinic and the OT. even allowed me to scrub in for a thyroid surgery. that's another story grins i was creating a mini chaos in the OT with the scrub nurse and anaes dr. trying to instruct me in mandarin to make sure i donned on the sterile apron and gloves correctly. extremely pai seh...

i previously mentioned i had knowledge ego problem lol hee and had loads of trouble reading chinese characters off the computer etc. i had wanted to give up and go back to msia to tell juniors who were so called bananas like me not to do an attachment in taiwan. but i've had a change of mind. :D

i seriously learnt a lot in this hospital. not just knowledge wise, dissecting ecg charts and x rays and ultrasounds (still horrible at it but less blur), but humanity wise.

the nurses and dr.s here treat the patients really really well. the rapport established is extremely strong and the patients love their dr.s. ev1 treats one another with utmost respect. ev1 greets each other in the hallway / wards / lunch place. regardless whether they know you or ur status. i never saw enough of this back in msia.

and technical barriers can be overcome. hehe. its also partly bcz i've got friends doing the attachment with me and helped me a lot in reading signs and all that. i'm not sure if my mandarin improved? grins. but i picked out (not up) some taiwanese accents that i find pretty amusing teehee. so... i think i would really recommend ppl who are even tho partial bananas like me to come attach here. :D

owh! and i found a cousin i've never met before in taipei. huge surprise lol. but extremely pleasant. heheh.

its my last day touring taipei today b4 i head home and start sch again. i'll miss this place. XP

starting 4th year with psychiatry. wish me luck. :P

Ergonomic?

today we visited the Tzu Chi temple/headquarters in should i say the heart Hualien? hehe. and did some voluntary work there. it was a privilege and an honour to be able to meet the founder of the Buddhist Tzu Chi Foundation, Dharma Master Cheng Yen in person. she was really friendly and welcoming :) we split into 2 groups to work on 1. gardening - the foundation has their very own vegetable garden where they mass produce their own organic vegetables. great for a very healthy lifestyle.

2. and secondly, in the Dried Rice factory. we did packaging work.

being air-con loving and having extremely enthusiastic outdoor loving friends teehee, i ended up in the 2nd group doing packaging indoors. now this is a 1st hand and 1st time experience working on packaging in a factory. (it wasnt really a factory la actually cz the condition was pretty comfortable and it was air coned. :D) so throw away all images of a dusty grey room filled with machines.

now after about i think 4 hours more or less of standing and sorting out packages + sitting down packaging small packets of dried rice + preservatives + flavoring working on a low table, i say:

SALUTATIONS to all factory workers in this world.

*thundering applause*

midway process i was suffering from:

1. superficial scratches on my fingers

2. boredom

3. stiff neck - cervical disc prolapse alert!

4. freezing arms (ok lar i hav no reason to complain about this 1 hehe)

note note: i am in no way complaining about the work. i was really happy to help out and after how much the tzu chi foundation has been helping me, giving me the opportunity to do my elective posting in their hospital, this is just sth really minor i can pitch in to contribute. plus the ppl are really nice and hospitable.

i'm just illustrating what a factory worker goes through in her workplace. :) dont get me wrong yeah :P

now i really know how important it is to establish a safe and comfortable working environment (cue Public Health posting hehe) esp, for blue collar workers. most of us have taken for granted that hard manual labour = suffering uncomfortable conditions

not so after all. and shouldnt be the case.

even hard manual labourers should be afforded and given the best (meaning safest, least ergonomically hazardous) working environment.

1. gloves to protect the hands

2. tables / chairs at the correct height to avoid painful neck bending for long hours

3. necessary safety precautions

4. music? to soothe the senses hehe. or varying jobs for the worker once in a while.

i wont go into too much of that in detail. most of us do know what needs to be done to form an optimal working environment. reducing risks via reducing hazards and exposure.

let's just not forget about helping and giving others the most humane working environment we can afford them when we are in the position to. :)

From Where I Am

being in a foreign land makes the heart grow fond of home.

truth to be said, i'm homesick. lol.

it all boils down to being optimistic or otherwise i guess. cz everything has its ups and downs, pros and cons, challenges and sweet memories.

i'm currently doing my elective posting in Tzu Chi Hospital in Hualien, Taiwan. now most ppl paused for 1 second for the msg to sink in, then open their eyes real big and ask,'dont u hav2 speak mandarin in Taiwan?' n i'd say 'awww come on, my mandarin has improved over the past year with me being forced to practise speaking to elderly chinese uncles and aunties in the hospital... i'll survive.. it cant be thatttt bad.'

3 days into the posting, (in internal medicine, Respiratory) i've been complaining non stop to my friends about hitting my mandarin quota, listening (mostly) and communicating in mandarin. on my 1st day i was utterly lost, blur, slightly miserable at being unable to read the instructions on the computer, building signs, not understanding what Dr.s are discussing in seminars esp when they discuss management cz they use a lot of mandarin medical terminology.

plus the style of teaching in this medical school is really different. every student gets attached to one supervisor. 1 to 1 or 2 to 1. they are given 2 patients each and they plan out the management, write case notes like a houseman for that patient. every morning they consult their supervisor about their patient and they offer suggestions on Diagnosis n plans to the Dr.s, even if the Dr. is like an MO or Specialist.

now think what would happen if i tried to offer management advice to a specialist back in msia. *shudder*

the Dr.s take in every suggestion seriously. and explain to the student the rights and wrongs of that decision etc. in a super nice non sarcasm filled way. this makes their students very voluntary in offering suggestions and answers when questioned. the students tag the Dr.s like 8am-5pm every single day unless they have classes. WOW...

i was taken aback at this culture n it took me some time to get used to it. found it extremely pleasant. n the Dr. even requested every1 else to communicate in English bcz he knew my mandarin's horrible.

the dr.-patient relationship here is really amazing. super ppd skills alert!

however, i find myself spiralling down into depression bcz i feel so inadequately equipped with knowledge compared to the students here. gosh. the students here are like super whiz kids with compartments in their brains for physiology, patho, pharmaco, everything.

the Dr.s are extremely nice and understanding and give leeway for my dumbness tho thank goodness. bt that doesnt take my ego of feeling miserably dumb away. lol. i went through a cardio lecture today where we're suppose to identify heart sounds. now in UKM the Dr.s say u dont hav2 go into too much of details, MR/MS/AR/AS is enough. fullstop. here, u have to be able to identify S3, S4, gallop rhythm, ejection sound etc.. they identify murmurs without timing with the carotid pulse. nt sure if that's a good thing, but, big wow.

but thr's a different side to it i guess. while Msian universities place emphasis on History taking and PE, the hospitals here focus on Diagnosis, Investigation and Management. CT scans are really really common. n students here know how to read ecg (super detailed, even those uncommon stuffs they know), xrays, ultrasounds, PET scans, CT scans almost like a pro. they were given very detailed classes on it and study it with detail as well. another wow.

there's 2.5 more wks to go in this elective. but as i mentioned in front, although i do know it really is beneficial and certainly good exposure, i miss home. where familiarity breeds comfort. i guess that;s how it feels when i start working whr the environment's going to be totally different too. maybe its just bcz i've not been in any transition period for a long time, the last 1 being my 1st sem in uni. been in my comfort zone for too long. n i miss church. heh.

home, home. how i long for thee. XP

New Discoveries

Just had a tour around Kuching for the past 3 days together with Pei Sun, her sis and her parents. They are extremely good touring company. XD

perfect excuse for me to savour all i-dare-say healthy Kuching delicacies annually. :D

even tho this was my 4th time touring Kuching over the past 3 years, i still keep discovering things i didnt know about this lovely city i call home.

1. We visited the Semonggoh Wildlife Rehabilitation Centre today in search of orang utans. a few facts that were new to me today.

- 1st of all i kept calling it Semonggok n only realised its correct name today. lol.

- Feeding Time for the orang utans are at 9-10am & 3-4pm. so if u're planning a trip here, u'll wana arrive just slightly before the feeding time :)

- The orang utans had really awesome names.

There's a female orang utan nicknamed Hot Mama due to her temper (not bcz she's irresistibly attractive to the males). Later after the hype only we rmbed her name's actually Delima. the park guides have great sense of humour :D

A dominant male orang utan called Ritchie who caused 2 fingers of George (another male orang utan) to be bitten off and poor George to be sent off to the Matang Wildlife Centre to separate the two.

and a female dubbed The Grandmother cz she's oldest.

one can never get bored watching the antics of these primates that are so irresistibly adorable, esp the babies! awww......

-The centre has 20+ orang utans. They are orang utans seized by Immigration Officers from poachers / smugglers and thank goodness, saved.

- and it's a lot nearer than i thought from my house and very easy to find. :D

2. I never knew there were that many Vegetarian outlets in Kuching. Pei Sun's family is vegetarian. so as we cruised around town, we started spotting more and more vegetarian restaurants around. We tried only a few, but out of those we tried, i have some good reviews.

- Popular Restaurant on the same road as the Air Asia Office opposite Swak Plaza, but much further down nearer to the Padungan roundabout. for restaurant standard, ordering dishes chinese styled.

- Beside the police station on the same road as Hong Kong noodle house in Padungan. 4got the shop's name tho. :S but it's vegetarian laksa, kolo mee, tomato noodles are not bad :P similar to non vegetarian 1s. it has kueh chap too , much to my surprise :P cz i didnt noe they could have mock pig intestines. hehe. bt it tastes different, more like bak kut teh. so i was glad they could all have a taste of Swakian food.

so if u've got vegetarian friends / am craving for vegetarian food, these are the places to be.

3. and rediscovered many routes around Kuching as i drove, drove, drove. :P

when i was small -yes in age and size- lol., i used to think that a 30 min drive down to the Damai Beach was horrendously long and super tiring.

after being in kl whr getting u to a destination requires a minimum time of 30 mins, a drive to Damai Beach felt like a drive in KL on any ordinary day. and much more pleasant with long endless empty roads and lots of trees. hehe. thank you KL for developing my travel time tolerance. :P

as the tour reached its end, nostalgia set in. i miss sunny and family already! she claims ownership over a certain Hill in Kuching selling ice cream. 8P

and its time for me to leave home once again. tmr.

sad..... :S