Tuesday, March 20, 2012

Questions No One Knows the Answers to

When does the universe starts? How does it feels like to be a dog? Questions always, ALWAYS, sounding in my mind but when people asks, "So, do you have any questions?" I would just look at my pedicured toes through my shoes and murmur, "No," because there are always questions that have no answers...at the moment.

Are there really questions no one knows the answers to? These are questions because we are bound by time and space. It's just matter of these obstructions, otherwise, I believe there's an absolute answer to every single question our mind could ever think of. There is One who knows all the answer and I think you know who I am talking about.

Monday, March 19, 2012

Random monologues of the day

  • I wonder what would happen to a woman who rather spend all her money and time on real knowledge than dresses and make-ups, or plastic surgeries
  • Is there such thing as "I am busy to talk to you right now"? Excluding the case of a superman who is on a mission to save the world from damnation in less than an hour, no one's ever too busy for their loved ones. Unless, they have something better to do than to talk to you. 
  • While I was reading "He's Just Not That Into You"  by Greg Behrendt and Liz Tuccillo this afternoon (please, don't take me wrongly, not that I'm desperate or anything, I just need some amusing reading material to laugh at after reading Angels and Demons in 2 sitting. That was a marathon for a slow reader like me), an excerpt from Mere Christianity, by CS Lewis struck me:

And, of course, the promise, made when I am in love and because I am in love, to be true to the beloved as long as I live, commits me to being true even if I cease to be in love. A promise must be about the things that I can do, about actions: no one can promise to go on feeling in a certain way. He might as well promise never to have a headache or always to feel hungry. 

To love is different from to be in love. This is not a trick on language but Love is an action, not a feeling. It is a command from Jesus Christ to all human beings, not a chemical reaction due to surge of endorphins in our arteries. Just a twist of perception, all the promises and songs (e.g. "I will be in love with you forever"), seems very "laughable". 

  • Finished my TMC Attachment. Forgot to update on the last day. This attachment couldn't have ended in a better way. I witnessed a Caesarian delivery and it was my first time looking at newborn, as in NEWBORN baby. He looked pale and bloodless at first, but very very adorable after a few seconds as his cheeks began to turn pink. Then his chest expanded and contracted as he breathed as hard as he could while we monitored his heartbeat, each beat full of eagerness and energy. Magical moment. :) Plus, the OT staffs were really warm on this day, despite my very brief stay here. So I'm having a few days free here in Kuching and Miri before my trip to Taiwan. ooo can't wait! 

Friday, March 16, 2012

Day 9 TMC Attachment

"What am I supposed to do? I was trained to be a doctor. I know how to take someone’s pain away, how to make a stopped heart beats again. We brought people’s kids back, their husbands…I have the skills to help people, is it ok for me to walk away from that because I want to just have fun?"
- House, Season 8, Episode 2: Transplant.

I observed knee joint replacement surgery with Dr Yu and a resident and laproscopic partial nephrectomy with Dr Teh today. The orthopaedic surgery was really funny as the old woman was on LA, she was having a great time telling me her stories about her basketball days while I was rather embarrassed because I couldn't stop laughing at her stories in the OT while the staffs were sawing, knocking and drilling away  on her knee. It was my first time looking at those prostheses as well. Impressive things they have there. Orthopaedic surgeons are just like carpenters. ;)  The nephrectomy was rather the same as yesterday: filled tummy with CO2 and punched 4 holes, get the cameras, scissors and clips, gauzes in, cut cut, sew, pull out the specimen. Sounds easy but it was an awfully long process. A great sense of humour is, not a bonus, but essential  part of this career. You won't want to bore your colleagues, patients or yourself out. Working for at least 12 hours per day, without those laughters, you'll burn out easily, break like a twig. 

The wards were great, I mean, more people have recovered and have gone back home. Only, there was a pyrexia of unknown origine, aka PUC. Will have to observe until the blood culture is ready and pray that gentleman will be ok. And, saw a very interesting case of renal vein thrombosis. Hmmm.... :)

Got a brief FOC lecture from 2 UNIMAS professors too. They were taking bone marrow biopsy in one of the wards and I just...leached on them. They were really great teachers, I mean, they know how students usually are - shy and all. So instead of waiting for me to ask them about every single thing they do, they just explain along the way. Saves all the energy. The process looks painful tho. :/

It's mid of March already. Frightening ey? Time is passing by so quickly. I wish I have more time. 

p/s: No posts for yesterday because other than the rounds, I hid in the clinic and study because I was attacked by that stupid nose allergy again. I need to stay in the OT more, that's the safest place to avoid any sort of nose allergies. 

Saturday, March 10, 2012

Day 5 TMC Attachment

Half day for today but EQUALLY tiring. I wonder what makes hospital so energy-draining. I am drop dead tired at the end of each day. Nevertheless, each day is a priceless and fun experience.

So for today, I didn't follow Dr Lau for rounds (had the chance to, but stick around at the babies' ward instead, super chubby babies!!! :D) but went to the OT. 9 o'clock at OT 3, Dr Wong.

"Be well fed, well prepared and punctual with your scrubs on. Drink a can of coke before you come in, you don't want to faint inside, it's gonna be a long day," I was warned.

Every one there seemed to be afraid of this doctor who apparently, bear the same name as my dad, whom, many people at his working place were afraid of him too. I heard Dr Wong's strict, he should be anyway. He's a neurosurgeon. Yes, I observed a neurosurgery, live, right in front of my own pair of eyes. Thank God for the opportunity for I'm not even a med school student at this stage.

Was I scared? Erm...not really. Perhaps I'm quite numb about the idea of blood and brain juice pouring, just as I was warned again and again throughout the years. When the scalp was opened and the cranial bone lay there openly, I wasn't feeling anything unusual, just amazed. O.O 

It was a surgery to remove the cerebral tumour on the parietal and frontal lobe so here comes the hand drill and electric drill buzzing away. You can see the  powdered skull floating in the air as the blade came in contact with the bone. Yea, I know, you might be picturing a mad doctor cutting people's skull into half and leave the brain exposed like that, doing the evil laugh all the way. That was what I had in mind before. Heh. However, the piece of skull cut out was just a very small piece on top of the head. After the skull, he was going through the 3 layer meninges. :) <- I have no idea why that appeared.

 Dr Wong was really careful and delicate. The exposed area was really to the minimal and you can barely see the massive tumour from far. As he was working with the nurses through a huge canggih-looking microscope, I enjoyed the "show" on the TV. It was after all, a theatre, right? 

No photography allowed in there so here's a sub googled picture.
 It's something like this. You get the idea.
It wasn't hard to recognise a tumour but the problem with this patient was the tumour wasn't encapsulated in one big bag. It was crawling all over the place. In order to remove the whole thing out, it has to be slowly broken down with ultrasound and suck out, bit by bit, be extremely cautious not to injure any neighbouring arteries, veins and nerves. The whole process was painfully slow but this is indeed, an extremely stressful procedure, you won't want to mess the patient's life with any accident, as if any is ever allowed there.

The whole surgery lasted for about 6 hours and I really respect Dr Wong for his stamina, patience and skills. Try standing still for 6 hours. Bad enough? Try standing AND working through the microscope with tiny equipments on a person's brain. Utter madness under the mask of awesomeness. I was only there observing. After standing for 2 hours, I just grabbed a chair and sat at the side. After 3 hours, even I as an observer was TIRED and the nurses changed shift, Dr Wong was still there working. 4 hours mark, I rushed home to have lunch and sleep while he continued there. No toilet break, no meals. Standing straight and working for 6 hours. 

Neurosurgeons are supermen. 
I want to be a superwoman.

That's it for this week. Another week ahead. Can't wait.
End with... Senor by Paris Combo. Enjoy!

Panic F button

Olfactory nerves (I), Optic nerve (II), Oculomotor nerve (III)....what is four?

*panic panic*

*new tab, "F" on address line.*



Trochlear nerve, trigeminal nerve, what is 6?

*Facebook a while more*

7, 8? omg.

I fear for the days to come. :p

Friday, March 09, 2012

Day 4 TMC Attachment

  • Round ward with Dr Lau, as routine but today, many of the patients we've seen yesterday seemed much better. No new admission. :D
  • Went to visit the haemodialysis department today and had a brief tour around. Similar to the other dialysis centres but TMC has really clean and comfortable ambient. I wonder if they pay more here. 
  • Spent the rest of the morning at the Radiology Department with Dr Vincent and Dr Lee. Tho not as advanced as SJMC's imaging dept, I have a pleasant time hanging around the CT scan area and X-ray area. A woman almost threw a fit during her CT scan due to her allergy to the dye used and partly it's because she's too weak. It was scary, but her vital points were all fine so they just fed her glucose solution and continued on. She's ok. :) And, I saw a newborn baby taking X-ray too! Super cute baby. His cheeks are so "pinchable" :D Met Dr Simon Huang there too. 4 of us had a good time chatting in the office. It was really pleasant leaching up to them. haha. Dr Lee shared quite a lot of stories about her son and can you tell me how to react, when a doctor called you a genius when in fact, your brain is as empty as possible after being idle for months?! It was a very awkward and embarrassing moment. Haha. But the conversation with them made me realise even more that doctors are also humans with life away from work too. They all have very happy families. :)
  • Ah afternoon was really interesting. I finally went into the OR and observed a surgery at the side. It was the removal of benign epithelial tumour, intraductal papilloma at the tail of parotid gland. Of course, it was bloody, which surgery isn't? Blood spurted, bp going up and down but it was fine overall. It almost an anatomy lesson on the facial nerves for me tho I was again, confused but learnt a massive load of stuffs. The OR was not as solemn as I thought. The latest hits are on (not full blast) in the air as the doctors and nurses occasionally cracked jokes. Ah, my dream work place. See, you can put any music you like in the OR, no problem as long as you can perform at your best. :)  
  • Received another warning for my ambition to specialise in neurosurgery. No family life, worst than hell, stressful, short life span as a doctor, limited, too specialised, not for women. I knew all these but I still don't think these should obstruct my desire to be in this field. They said I don't have a family at the moment so I probably wouldn't care much about that part. Perhaps, but give me 10 more years to decide on what should I specialise in. I have an opportunity to observe a neurosurgery tomorrow, it'll be a long, fruitful and exciting day. 
Study time :D

p/s:  I laughed so hard on my naiveness and stupidity when I was reading my previous posts on SJMC attachment. The fact that I will laughed at what I write here one day in the future is not stopping me from writing. I mean, all of us laughed at our past when we look back in retrospect and what else is there to be ashamed of? We all grow. 6 years of blogging isn't that hard. :)  

Thursday, March 08, 2012

Day 3 of TMC Attachment

The day started really early today. People were crowding in front of the clinic even before we arrive, as usual. It's really scary, as if the people will eat you raw any time you walk near time but it should be something a doctor should be proud of: at least, it is an indication of how well your reputation is out there.
However, today I didn't stick around the registration counter but followed uncle for the ward round. It was quite different from the Miri GH's and SJMC's ward rounds. Unlike the huge number of housemen you have in Miri GH trailing the senior like caterpillar, the doctors here have to do ward rounds by themselves many times, especially when there aren't enough nurses. They carry the bp set and files around on their own. It may look messy at times, but there is plenty of freedom, except for my uncle as I am  currently leaching to him like nobody's business. And unlike the arrogance of RICH patients you have over at SJMC, TMC (for rich people too) doesn't seems to portray that annoyance but posses the same level of comfort. Therefore, it's much easier to peep around, "eavesdrop", pop questions (instead of the "look" we got from SJMC whenever we walk around.) Excluding a little bit of complication at the ICU, the ward round was overall quite pleasant. I like ward visits because we are able to follow cases more closely, to see the progress of the patients from the moment they enter the hospital until the day they are discharged. :)
*COPD, COAD, stroke case. Oedema with pleural and pericardial effusion.

Clinic. Uncle said I am quite "fortunate" this time to have the opportunity to see 2 patients with right ventricle hypertrophy. One due to pulmonary artery stenosis and another with pulmonary hypertension. Those were quite rare, considering the fact that most cardiac patients have LV hypertrophy then angina then hypertension then high cholesterol...blah blah blah, the "normal" degenerative disease cases. Blame the medical rubbish! Many of them were victims of very very wrong rumours spreading out there, eg. drink 3 litres of water or as much water as possible/if you're not sick, don't take the med, it's harming your stomach/eat wheat only to slim down. Then, they ended up admitted into the hospital. Couldn't blame them, I am also a victim of these medical rubbish occasionally, but have to be grateful for my laziness then, cause usually I don't cling to any of these rubbish.

Ah, MY ALLERGY! My hyper-sentitive nose has been causing a lot of trouble lately. When I helping out at the pharmacy yesterday, my allergy attacked and I was sneezing like mad that I have to, again, wear a mask inside the pharmacy to work. So awkward. =.=" Let's pray that I'm not allergic to smell of any of the meds there, but to the dust only, if not, I'll be so cham next time.

I will not go very detail for the posts of this attachment unlike for the previous 2, though in reality, this attachment has gone much technical. still shallow tho compared to what I am supposed to know. I have been working on cardiac & circulation related physiology these few weeks and am VERY confused with the abnormal ECG part and the physics formulae parts. WHY ARE THE SYMBOLS DIFFERENT?! F is volume of blood flow per minute. Why not V?? Why is Ohm's law F=P/R and not R=V/I? Mutant formulae!? :/ and...My SAM Maths teacher, Mr Munin once said, "In one point of your life, you would be confused of your left and right." Perhaps,  this is the point? I'm still getting used to the diagrams and inverted left and right in them. Did about half of the anatomy for mediastenum region too? Uncle said he is going to screw me this weekend on the anatomy part. Dai, study. :p

Unrelated stuffs: (I need to craptalk a bit to loosen up)
Today is Women's Day. :) It's March and it will be end of March really soon as my schedule will be packed like madddddd until end of April until the madness starts again in June until it's time for departure in September. However I know that I won't be any free in May. Got a few ideas in my mind, evil plans for world domination. ;) Time passed too fast. My initial perception of enjoying super long holiday is not a single bit close to LONG any more. 11 months holiday is too short to really complete anything, all the more I'm on marathon travel schedule. I counted yesterday, since A2 finished, I've been to 22 different places in the account of 4 months. Imagine the amount of time I spent just on travelling. :/
I sent a very outdated letter to Cambridge today using Poslaju. Cost RM87.50. I literally shouted at the post office when the cashier told me the price. O.O It's just a letter, not even a parcel! SUPER EXPENSIVE. Who says postmen don't earn much? :(

To end, I shall entertain you, my dear reader, by revealing the suppressed bimbotic side of me here. Feel free to attack me in the future with these if I ever get too dead, old, serious on you.

In cousins' room. :) 

Stripped dress: Elle
Handbag: Charles and Keith
Slippers: Fitflops

O piano!
\Haven't been practising for months!

Wednesday, March 07, 2012


If you've chosen the right career, you don't have to work even a single day in your life.

Maybe it's true. I'm happy with where I am and what I am doing now, even more, what I am going to do next and to meet people who will to be there with me and I with them in the future.

Oh, what a joy it is!

I am currently doing my third hospital attachment in Timberland Specialist Centre. I couldn't reveal anything here and I'm too lazy to reveal them here after finishing my report, I can only say it's such a blessing to be here, to learn so much from my dear uncle. He is indeed a patient, eager and tender teacher. This is a 2 weeks attachment. It could be longer but I couldn't afford to stay any longer. Need to prepare for my next destination. :P

Monday, March 05, 2012

Attaining perfection

For a dear friend of mine, who was tempted again and again, who was thrown in despair of sinning, but still holds on to the Truth,

We may, indeed, be sure that perfect chastity - like perfect charity - will not attained by any merely human efforts. You must ask God's help. Even when you have done so, it may seem to you for a long time that no help, or less help than you need, is being given. Never mind. After each failure, ask forgiveness, pick yourself up and try again. Very often what God first helps us towards is not the virtue itself but just this power of always trying again. For however important chastity (or courage, or truthfulness, or any other virtue) may be, this process trains us in habits of the soul which are more important still. It cures our illusions about ourselves and teaches us to depend on God. We learn, on the one hand, that we cannot trust ourselves even in our best moments, and on the other, that we need not despair even in our worst, for our failures are forgiven. 
The only fatal thing is to sit down content with anything less than perfection. 
- Mere Christianity, C.S.Lewis.

You asked me how to not sin. When you realised it's a sin and seek a way to correct it, you can be assured that the Holy Spirit has indeed work in you. I can only tell you the answer is pray to the Lord that you will not sin again and the practical, immediate action is don't do it again. I know it's easier said than done, but have faith in Him and He will bring you through. Hasn't He done that many times in your life? Temptations will many times try you, stay strong and above all, stay close to the Word of God. The Word of God is not only for comfort when you are in dire need of motivation, but it's related to all part of your life on your journey to be perfect - Christ-liked. Don't just read it on Sunday services or when you are wiping your tears, study it daily! I will pray for you. Take care.   

* 1 John 1:5-10

Friday, March 02, 2012

Brian Goldman: Doctors make mistakes. Can we talk about that?

Something nice to share.