Out of Silence

6 months on.
Life is still good.
Med school is a few chapters behind now.
Working life is nothing and everything like what people say.
You think hate your job, yet you are addicted to it.
You like what you do, but you complain about everything.
You count the hours to finish work and go home, but at the end of the day, you'll go, "Wow, time flies!"
Your boss is nice, yet you are blamed for others' mistakes.
Your patients will request to be transferred to a private centre for further treatment, yet thank you profusely before they leave.
You get pissed at silly things people do, but there is always a smile plastered on your face.
You work your ass off trying to get as much things done in a day, but there is never enough time for everything.
You try your best to be better than you were before, but there is always something new to learn everyday.

'Try harder.'
'You can be better than this.'
'This is not your full potential.'
'I believe that there's more in you.'
'I push you because I know you can do it.'

Words that your superior would repeatedly say. Words which make you wonder if you are cut out for the job. Words which make you doubt your capabilities. Words which inspire you to do your best, but you wonder if it is enough.

Then, one day, your boss would say,
'You're good.'

I love my job.

Time Stops

My favourite song from my favourite pianist Suzanne Ciani is a beautiful piece called 'Time Stops'.

It is a peculiar name to a song and I have always wondered what it meant. How can time stop? We try very hard to preserve our experiences, capturing precious moments in pictures but the reality is that we can never stop time.

People are always running out of time. We grow old and someday we would die. People face deadlines all d time. To a cardiologist, time is myocardium saved. There is always a schedule to stick to because even if we freeze and stop dead in our tracks, the rest of the world moves on. And we always hear the phrase, 'time flies'.

But for me, time has somehow slowed down. I could hardly believe that it has only been 50 days since my last post. In less than 2 months, so much has happened to me and the people whom I am very close to.

I sat for my final professional exams last month. During my exams, it did occur to me that time had gone by very quickly and I was at the end of 5 years of med school. That 2-week period was very challenging. Studying for exams was taxing but I got through it with a lot of love and encouragement.

My best friend broke up with her boyfriend in the middle of exams. It was shocking, and distressing. I went through a myriad of emotions during this time even as an observer, I cannot begin to imagine how she coped with the breakup.

After that, everything happened so quickly I could hardly keep up with the events.

I passed my exams and had to move out of my hostel within a few days. Leaving the hostel was difficult. I packed 3 years of memories in 3 days. Moving home was equally challenging. I am still having difficulties unpacking.

It has only been a month since I came home.

I learned to bake.
I went on some crazy outing with my friends and had loads and loads of fun.
I had an operation and now a fading scar on my skin.
I went on a trip to Hatyai, had lots of sweet, sweet mangoes and came back with a few additional bags.
I found out that the man my best friend was dating is already seeing someone else.
I spent many days with someone dear to me and had some truly amazing time together.
I am very much closer to my sisters now that I am home.

Only a month, yet I feel different.

I do not know who said this, but I believe it is true that the only constant is change.

And echoing Suzanne Ciani, 'Have you ever felt time stop? Have you ever been in love?'

Having lived it, I think I know what she meant.

A Walk in the Park

I have been taking a walk in the park the past 5 years.

5 years?!?!

Where exactly have I been?

Did I get lost in a labyrinth? Well, I don’t remember meeting Minotaur.

Did I prick my finger and fall into a deep slumber? I guess not, as I do not recall a prince who kissed me out of the grasp of the sandman.

Did I step into a crack in the fabric of time and was teleported into the future? I don’t think so. Most definitely did not jump off the Brooklyn Bridge.

I would like to think that I took an extremely long path. It was the path that was ahead of me 5 years ago, welcoming and bright, inviting, promising.

My walk for the past 5 years had been very interesting. There were times where I walked through the most beautiful paths, with lush greeneries and beautiful blossoms, bursting with life at every step that I took. Sometimes I had to climb endless flights of steps, every step an agonizing effort. I slipped many times, especially in the dark when there was no one around.

Oh yes, I had company. There were those who always remained acquaintances, hence our cordial relationship. There were some who called themselves friends, yet would abandon me when I had my knees deep in mud. Few stayed by me, pulled me out and kept me going.

I saw the exit sign some weeks ago, and knowing that I would reach the last mile by this time, I was gearing myself for this last league. The final mile is an uphill ascend. Sometimes I fear that I am not strong enough to make the climb. But I know it is silly thinking, knowing that I have wonderful support from people who are really true to me, and would be by my side at every step I take.

Evil Bites

I've discovered the most evil creation of mankind.

It is called Hup Toh So.

These cute little almond cookies are small, aromatic, tasty and oh-so light and crumbly. One cannot get enough of them once one had started popping them into the mouth.

The crumbly sweet bits simply melt in your mouth. I think eating this is better than eating ambrosia.

Found in abundance during festive seasons, this container of pure delight was a gift from an acquaintance.

I started with one innocent-looking piece. It was gone in a few seconds. Unsatiated, I took another, to savour its rich taste of almond, and then another, and another. I have been addicted to it ever since I started on Monday. This is the new opium. For me, at least.

You might wonder what is so evil about a few pieces of cookies.

Here's a piece of nutritional fact which will make you cringe. 2 pieces of this mini biscuit the size of a 20cent coin contains 160kcal. That is equivalent to eating 2 slices of bread!

And I eat at least 10 pieces of this sinful cookie a day. I cannot imagine stomaching 10 slices of bread in a week!

These almond cookies apparently contains lard(lemak babi!!) which makes it yummy and crumbly.

Works well with my tastebuds, definitely not with my weight :(

But like all other Chinese, we would say, "Once a year only mah."

Feeds the metabolic syndrome, surely. What the heck, we only live once.

Happy Valentine's Day, by the way.

14.2.2008(4.33am) - I forgot yesterday was the 7th day of Chinese New Year, which is the common birthday of man. Darn... all these years I would celebrate at home with my family. Next year, perhaps.

Revision Blues

Today is the 5th day of Chinese New Year.
It is also pre-exams day.
This is our exams week for the Orthosurgery posting. I have Surgery clinicals tomorrow, Orthopaedics clinicals on Thursday and theory paper on Friday.
Feels horrible to have a holiday turn into study leave.
15 days of Chinese New Year might seem like an over-indulgent affair but like most Chinese, I celebrate any cause to makan :)
My brains are in a state of denial! I've been staring at my books for hours and yet there were no synapses at my amygdala. Don't even talk about my amygdala....I wonder if my Wernicke's is fully functioning at the moment.
What is this?

Where I am sitting, this looks so much more tempting.

*Sigh*

I am a month away from my finals. Haven't really had the time to reflect back on my 5 years of med school. Sometimes I wonder what is my most important lesson in med school.

As a med student, the doctors and lecturers keep telling us that most of what we learn in med schools will not be what we see in future as doctors. We are now at the textbook level, and we do not always find textbook patients. The practical aspects of being a doctor has to be experienced and learned that way.

For now, a med student has to sit for her exams in the midst of Chinese New Year and Valentine's Day (not that I have a date anyway).

"Medical practice is not knitting and weaving and the labour of the hands, but it must be inspired with soul and be filled with understanding and equipped with the gift of keen observation; these together with accurate scientific knowledge are the indispensable requisites for proficient medical practice."

~Mosos ben Maimon (1135-1204)

Date with Death

I have a date with Death, but the time is not confirmed. I think he will give me a surprise when the time comes. I know he is like that.

Though I have seen him many times in the hospital, he never once looked my way or greeted me. Maybe he was saving his thoughts for our date. Or perhaps he did not have the time, him being such a busy man.

He is an enigma. I could never tell when I would see him. Sometimes I could see him waiting at the corner for many days for the septic lady, or the man with terminal cancer. Sometimes he would come unannounced, kiss the lady in labour and leave as abruptly as he had arrived.

He seemed to like children as well. I had seen him cradle babies in his arms, and they stopped crying. He was the one who led May out of the hospital, holding her little hand in his own. That was the only time I saw May walk, but she was walking away from me.

When I was in Teluk Intan last week, he came for a young Hunter. I heard he was watching this boy for many years, staying in close proximity but never had direct contact, not until now.

I read in the papers that several days ago that he was on a bus which crashed on the highway. He was unharmed, and left the crash site with 3 youths. It was unexpected, even for these 3 young people. They were not prepared to leave. They had not left any goodbyes for their families, but his magnetism was too strong for them to resist.

I would be seeing him on a regular basis when I start working. There would come a time when I have to stand against him, telling him to leave. He must know that he is not welcomed all the time.

Still, I know he will not listen to what I say. He comes and goes as he wishes.

He might even steal a kiss from me before my time.

The Finer Points of Learning

I attended my team's clinic yesterday. As our team specialise in colorectal surgery, a majority of our cases seen were bum cases.

I arrived early and managed to clerk a new case which had to be presented to my specialist later on. A colleague of mine was already tagging the specialist in his clinic when I arrived. They were seeing this patient with haemorrhoids, and was already examining the patient behind the screen. I joined them after obtaining permission, and the scene that greeted me was really quite hilarious.

The patient was on the examination couch, lying on his left, legs bent to allow optimum exposure of his rear end.
My specialist had already inserted the proctoscope, but very strangely, he was looking away from the patient and looked as if he just licked bile.
My colleague was standing at the foot of the couch, giggling silently.
There was a strange smell within the cubicle.

I think my specialist took a blow in his face. (LOLOLOL)

I took a peek into the proctoscope, and saw some faecal material within the proctoscope. Looked like the patient did not answer nature's call that morning.

To cut a long story short, the patient underwent a rubber banding for his haemorrhoids.

I learned that we cannot be too enthusiastic when doing a proctoscopy... Do not stand so close when removing the probe, and be careful of noxious gases.

To all those who will not be peeking into other's bums in future, remember to empty your bowels before seeing a bum doctor.

Learning the ropes

Surgery is not my favourite division of medicine. In fact, it is probably my least liked subject. And it is not because I am haemophobic.

There is just something about surgery that gives me the chills. Personally I find surgery relatively messy, dealing with abscesses, intestines, infected wounds, hernias, cancers... The list goes on.

When I was in my 3rd year of studies, I did a 10-week rotation in surgery. Needless to say, I wasn't the most enthusiastic student and only spent enough time to learn the basics, whatever was necessary to pass the exams.

Now that I am in my final year, and in my final months of studies, I find myself going through this rotation again, this time for a much shorter period, only 4 weeks.

I am taking more interest in surgery now that I am almost completing my training, voluntarily doing or assisting in procedures.

After a whole morning in the clinic yesterday, I realized that there is more to examining a patient than what medical school can teach.

I've already been reminded of the importance of wearing gloves in a previous post.

Yesterday I remembered to wear the latex fingers before performing a rectal examination... But I only wore it on my right hand. I thought that since I was only going to use my right index finger, what's the point of wasting another glove for my left hand?

I only saw the point after applying KY jelly on my finger. I needed my left hand to part the err... you know what I mean. So there, bitten by my stupidity again.

That was for the rectal examination. I was observing the house officer inspect another case, this time a fistula in ano. I could never forget how bad the smell was... It reminded me of smelly salted-fish with belacan. Ughh....

So lessons from clinic :
Always wear gloves on both hands. You never know when you might need your hands or what you will touch.
Always wear a mask when examining a fistula in ano.

I am wiser now.

Kitty Meal

Tuesday night and I'm bored out of my wits! I was going through some of the photos I took with my phone and found some pretty interesting pictures.

It was New Year’s Day 2008 and I was on my way to the ward (yeah, talk about no life!). As I was walking down the walkway, I came across some odd looking pieces (and a cat) lying on the floor.

On close-up...

(Tail)

(Jaw)

(Sleeping cat)

Feline post-prandial narcolepsy.

Was it a rat, squirrel or another cat? I'll leave the guessing to you.

How's that for a New Year meal? LOL.

Growing pains

I went out for lunch with a coursemate of mine today. I haven’t seen him in almost a month, as he had been regularly missing our classes. By chance, we met in the library today and decided to go out makan.

He told me he was going to quit med school, and that was the reason he was back at the faculty.

I was not stunned by his statement, as he had been saying this throughout our academic year. Still, I was very surprised at his decision to quit now when we only have less than 3 more months to go.

I asked him why not complete this degree as an insurance. After all, we had gone through almost 5 grueling years of studies. Just 3 more months to make the whole 5 years worthwhile.

He told me that he could not bear to go through this kind of life anymore, and since he will never walk down this path again, what good will the degree do anyway.

His statement made me think of another friend of mine who quit college to run his own business, and after some hits and misses, he is doing well now. He told me that he was not gaining much from college, that the qualification was just a piece of paper anyway.

My encounter with the 2 of them made me question my personal objectives in life. I was raised with the mentality that academic qualification is the most important acquisition of our lives. I grew up believing that a degree is my passport to success. Almost all my friends are graduates, and my sister even obtained her Masters degree from Cambridge.

“Middle class mentality”

Those were the words of my lecturer 4 years ago. He once said that a majority of our society is stuck in the middle class mentality, where we were raised to study hard as children, get a degree, get a steady job, find a spouse, and raise a good family.

In other words, “Play it safe.”

I am a safe person. Maybe it is because I have been protected by my parents all my life. They had kept me safe, and I am very comfortably snuggled in my cozy cocoon.

At this juncture, just months before I attempt to spread my wings, I do not know how successful I will be as a doctor, a daughter, a wife, or a mother in future.

And qualification might not be the most important thing in life after all, but I still would not dare to venture out into the world without my MD.

I admire the courage and determination of my 2 friends, and my second friend is an example of making life work come what may.

After all that had been said, I have come to realize that the wisdom of growing up is something of ours forever.

And that is what I will hang on to.

My Hands

I did something quite dumb today. I examined an inguinal hernia without wearing gloves!

No, it's not a deadly sin, but would have been better had I donned the gloves. The purpose of the gloves is mainly for hygiene sake, protection for my own good against body fluids of a patient.

I only thought of those darn latex after I started my palpation, when I felt that something was not quite right. Everything felt so....distinct! Only then was my mind flooded with the same message,

"Bare hands! Bare hands! Bare hands! Bare hands!"

The joke is on me, really. Moral lesson of the day : Don't forget your rubber.

I won't, hopefully :P
Thankfully there were no secretions or discharge. Phew!

My Way

The Road Not Taken

Two roads diverged in a yellow wood,

And sorry I could not travel both

And be one traveler, long I stood

And looked down one as far as I could

To where it bent in the undergrowth.

Then took the other, as just as fair,

And having perhaps the better claim,

Because it was grassy and wanted wear;

Though as for that the passing there

Had worn them really about the same.

And both that morning equally lay

In leaves no step had trodden black.

Oh, I kept the first for another day!

Yet knowing how way leads on to way,

I doubted if I should ever come back.

I shall be telling this with a sigh

Somewhere ages and ages hence:

Two roads diverged in a wood, and I--

I took the one less traveled by,

And that has made all the difference.

-Robert Frost-

At this point in time, I imagine that I am Robert Frost when he was standing in the woods where the road diverged into 2, and while deciding which road to take he wrote a poem.

The latest issue in my life is deciding on the hospitals to apply for my housemanship. Everybody asks the same question,
"Do you want to go to Sabah or Sarawak?"

I had decided some time ago to apply some place near home, but personally I have no objections going to Borneo. It will be a challenge, to start a new life away from home, away from my parents.

I do not know if there is a difference staying in KL. Work exposure and workload should be the same. I am still going to be a houseman for 2 years. I still want to be a paediatrician at the end of the day.

So now I am standing at the diverging road, wondering if I should stay or go. If I decide to go, all I have to do is to tell the authorities during my interview, and I'll be on my way.

Do I follow Frost in taking the road less traveled by? Knowing how way leads to way, if I go, will I ever come back?