dilemma

I'm trying very hard to resist going back to Malaysia for good after I finish my foundation training.

But I wonder how long I can stand it here ..

28/10/2010 - the Great Dundee Thundersnowstorm

We are all snowed in today.. torrents and torrents of snow kept falling..

Roads closed.. shops closed.. buses stopped..

Fortunately some of us survived.. :P

(There was actual thunder and lightning along with the snowstorm this time.. not seen that before)

first, do no evil

Today, I looked into the eyes of an elderly lady.

I want to go home today, she said.

Can I go home? she asked tearfully.

--

Yes you can, I answered forcing a smile.

When did the hospital become a prison? I thought.

Is it possible that we care too much sometimes?

8854: a dream

I turned on the tap at the foot of the bathtub, filling it with water ever so slowly.

Looking down at the water pooling around my feet, I waited. Warm, but not hot enough, I thought. This will do.

As the water reached the brim and overflowed, I slid myself down and lie in the tub. Without warning, the water coming out of the tap turned colder all of a sudden. I wasn't really bothered.

A few seconds passed, minutes? and somehow I brought up enough courage to do it. I lowered my head beneath the surface.

Opened my eyes. I could see the underside of the water surface. Glimmery, shimmery, surface that showed a distorted view of the outside world.

And then I took in a big breath.

I realised I could breathe.

8853: home?

I'm home, here in our new house, hidden deep among oil palm trees. I've been home for almost a week now, having gone through a family holiday in Paris and Edinburgh, and my big day: graduation. That's it, I'm a working adult now.

And so begins the next phase of my life, the longest one: my working life. Still lots of question marks surrounding my own future, biggest of all the where and when. At least I know what I want to be, now I just have to figure out the how.

--

Though something has been bugging me since I came home. I've only been back for almost a week, yet I can't help but wish I'm back in Dundee already.

Is it the independence I crave, that I can go anywhere I want, do anything I wish when I'm back there?

Or perhaps I'm feeling that it's a waste of time sitting on my bed all day, when there's paperwork and househunting to be done.

Amidst this, there's also another thing that pops in and out of my mind. An idea I used to cast aside, using reasons like obligations and patriotism to ward it off, as if that would convince me to make a stand. As of late, they weren't enough anymore.

Because for the first time, I'm seriously thinking of emigration.

Why? I'm not even sure myself. I think it's because I have lost my sense of belonging, my sense of 'home'. I feel like I don't belong anywhere. Like 'home' isn't confined within the boundaries of a city, a state, a country.

I felt like a bird which is set free from its cage.

Free. But without a home.

8826: i need a new heart

Of all the time in my life, I should be happy right now.

But why am I not?

I want to run and run and never look back.

Go somewhere far away and be lost.

Make myself drunk and escape from my life.

.. I think I'm depressed.

Update: Somehow, I'm back to my old self the next morning. This recurring slump is worrying me..

8808: 5 years.

Cliched as it sounds, it surely is a long journey.

Had my viva yesterday, a 40-minute Q&A session based on my portfolio. The portfolio that I rushed till literally the very last minute, forgoing sleep for all of 48 hours prior to submission. I was so burdened by the stress, I can't even imagine how I ever survived staying awake all night just typing away on my laptop. Trust me to procrastinate again, on probably the most important work of my life to date.

And the rut I got myself in surely didn't end there, oh no. Of all the examiners, I got the Coordinator of Surgical Shadowing AND the Dean of Medical School for my viva. Funnily enough, even though I was not really proud of my portfolio (goes without saying it wasn't the best of my work), I wasn't really nervous. I actually felt rather prepared, having spent 2 weeks studying and practising talking about all the things I managed to include in my portfolio.

On the day of my viva, as I walked towards the CSU, I felt like my whole world just centred around me at that moment. My whole medical education has come to this. I wanted to tell myself please don't screw this up, please don't screw this up, but all I could do was .. smile. I was smiling all the way walking to the hospital, down the stairs into CSU, sitting on the chair outside the room, knocking on the door, opening it to greet my examiners.

It just felt so unreal. I couldn't believe this is it.

And as if it was just my luck, the external examiner had to observe MY viva, among the dozens of other students. Not that it would make a difference. For the first time in my life, I felt like I could actually do it. My smile was genuine, and I can't even wipe it off my face, let alone anyone else. I still couldn't believe I have reached the light at the end of the tunnel.

"Did you enjoy doing your portfolio? Because we did enjoy reading it. If you could choose one part of your portfolio, which part are you most proud of?"

And it began. The defining moment of my life as a medical student. My last moment as a medical student, fingers crossed.

--

What I thought would be the longest 40 minutes of my life, passed me by in an instant. I just remembered talking so fast that my brain couldn't even catch up. The words just came out like I have memorised a script. I was on autopilot mode.

The rest of the day after my viva I couldn't get much rest. I was so excited, so nervous, so worried, that I couldn't get anything done, couldn't concentrate on anything at all. As it stands, the results was going be posted on the board at 9am the next morning, less than 24 hours after my viva.

That night I woke up a few times, not able to get any good sleep. Had to force myself back to sleep because it was not 9am yet, and I can't bear staying up all morning watching every agonising second pass by. Eventually 9am came, and I rushed off to the Medical School Office as fast as I could, with my heart in my throat. Now I know what that expression felt like.

Only to see my other fellow batchmates still waiting for the results as well. It was not released at 9am as stated. Which meant more palpitation-inducing minutes to wait. It was 9.30am when the results eventually went up on the board.

It almost drove me crazy waiting for the results list to be posted, but running through the list of names trying to find mine is even worse, if that's even possible. My eyes could barely focus.

And then I found it.

There's my name. There, buried among all the names of future successful doctors.

5 years of my life have culminated to this point, the point I had only dreamed of. Is this it?

Have I finally finished medical school?

5 years .. took me long enough.

*heaves the biggest sigh of relief in my life*

--

And I thank all my friends, batchmates, seniors, teachers, tutors, doctors, hospital staff, patients, and every single person who I came across in my life as a medical student. You have all made me who I am today, and I cannot even begin to express my gratitude enough.

Thank you for the most significant 5 years of my life. It has changed my life in so many ways.

I felt like I finally grew up.

8791: confession

Most people don't know this about me, in fact, most people never noticed at all. I guess I'm good at hiding it, I've tried to keep it a secret for as long as I can remember anyway.

But I have a confession to make.

I'd always thought I was different from others. You know, there's so many things about me that is not 'normal'. This was probably one of the biggest things I noticed about myself. Some close friends found out about it, and they never made me feel any different because of it. I'm really grateful to have these friends around, but it doesn't make me any less shy about it. I don't like people finding out and look at me differently.

So why am I making a confession now?

No particular reason at all. It's not that I'm not ashamed of it anymore, I still don't like people finding out, I didn't want to be 'different'. Then again, it's not something I can hide forever, nor will it go away just because I deny its existence. At the very least, it's comforting to finally find out that there are others like me and I'm not the only one 'different'. Perhaps I should accept myself for being like this, I am born this way after all.

So here it is. I'm telling you my big secret. Biggest one I've told about myself my whole life. Wait, this is not the only secret I've told actually. Haha. And it's not really a secret. But I digress.

...

So what is this big confession?

*big breath*

I have 'murderer's thumbs'. What's that? You know, my short thumbs.
For the medically inclined, it's called Brachydactyly type D

...

What? This is such an anti-climax? What'd you expect? :P

But seriously, it's kind of funny to find out that thing 'different' about yourself has a name to it. No, has nameS to it. They were also called 'clubbed thumbs', 'stub thumbs', 'midget's thumbs', 'Potter's thumbs', 'toe thumbs', and 'royal thumbs'. Apparently it's called 'royal thumbs' because they came from inbreeding within the royal family and passed down the generations. Wouldn't you know it, hey I have royal blood in me. Now where's my castle ..

Oh, btw it's called 'murderer's thumbs' by the people who's into palm reading. Not that I believe in these kinds of things, but here's an interesting excerpt which does sound a little true..

Those with this type of thumb usually display a strong will and a well developed control over emotions. As a result, when continually frustrated or bullied, they build resentment for months or years before exploding. When out of temper those with clubbed thumbs can clear a room in seconds, as others scurry for safety.

In almost every case of clubbed thumbs I have seen the person has not lost his or her temper more than five or six times in 30 years. In most cases this person knows on a deep level what he or she is capable of doing when out of temper, and is sensible enough to leave the circumstances which triggered the outburst of temper before doing something which will cause regret.

If a crime such as murder is committed, it is likely to be an unplanned affair after the person has 'snapped,' temporarily losing control over his or her emotions.

So there you have it.

YOU WON'T LIKE ME WHEN I'M ANGRY ..
I have the murderer's thumbs!

8790: one thing, many things

If you asked me to name one thing from my childhood which I associate most with being 'home', the above is what it is.

These miles and miles of plantation. All of my fondest childhood memories had been among these stumpy, thorny trees.

Yes, it's kelapa sawit.

I'm a kelapa sawit boy. At least, I was.

I want to be a child again, among the kelapa sawit.

--

I'm a little more nostalgic these days because we have moved into a new house (well, my family had), into ANOTHER kelapa sawit plantation. But.. it's not the same plantation.

There's no durian trees, where we pass by with hope and anticipation everyday during the durian season, looking out of the car as my dad slows down, hoping we'll be the first to spot unclaimed ripe thorny fruits beside the roadpath.

There's no banana trees that I walked by every early morning to take the school bus, where I quickened my pace every time I passed them because it's so dark and I think of those banana ghost stories.

There's no rambutan trees belonging to our neighbours, where we used to throw sticks at trying to get the bunches of rambutan down.

There's no local convenience shop in the kampung nearby, where we always hitch a ride on our dad's motorcycle to in the evening to buy ice cream from.

There's no bridge over the river which we cross everyday to get to our house, where once my brother fell over and was saved only by a metal bar halfway down into the river.

There's no abandoned dusty warehouses which smelled like no one's been there for decades, where we used to explore and jump on, puffing clouds of dust up under our feet.

There's no disused diesel pumps in front of one of these warehouses, which I've always wondered whether still contained any fuel.

There's no that warehouse-turned-badminton court with HUGE 5m tall steel doors which we have to push apart to open to get in and play badminton. And watch the badminton competitions which my dad used to join.

There's no puddle of mud where we once tried to make clay pots from, which was quite a successful attempt albeit them being so tiny to be of any use.

There's no that solitary 2mx1mx1m block of concrete with a locked steel door that I used to think had a monster trapped inside.

There's no that piece of roof tile with a mosquito shaped engraving which I found, thought was a fossil, and left in a secret place, but so secret that I forgot where I put it and was never to see it again.

I'm just hating this sinking feeling I get because we won't be staying at the home where I spent most of my childhood in anymore. And as time flows by, the memories of that home fades ..

I want to keep my childhood memories. Time, please don't take them away :(

8786: the end?

"Hey today is our last day of medical school .."

"Finally."

"The mythical last day .."

--

It wasn't until they mentioned it that I realised. Is this the end of my life as a medical student? Have we really reach the end?

I can't get my head around it.

It's been 5 years. That's 20% of my life spent in medical school.

I still can't get my head around it.

Oh well, first I need to make sure I get out of medical school first. Less than 2 months to go!

--

Come to think of it, I'd need to change the name of this blog as well..

8781: untitled

It's spring again.

Today I half-spring-cleaned my room. Reorganised my wardrobe. Reunited with a few long-lost pieces of clothes that I haven't seen for a long time. Said goodbye to a few more, as I packed them off to donate away.

Surreal, just surreal.

I'm moving out in 2, 3 months. Again. It hasn't really gotten to me yet, but I guess I'll feel it more when I clean up my room for the last time before I leave.

Not much time to blog these days, so many unwritten thoughts. Not much time for anything really. And amidst the blurred ongoings in my life, I added another year to my age.

So many things passing through my mind, passing through my life. So many words unspoken, washed away by the tides of time.

--

Today is 6 days to the end of 5th Year, the final year of my medical school
(fingers crossed).

9 days before our Progress Test.

13 days before Portfolio Submission.

23 days before Portfolio Viva.

62 days to Graduation.

--

Today is the 8781-st day.

And I want to go home.

I need to.

:(

lessons from the Pain Clinic

You know what's another awkward moment?
When a grown-up man cry in front of you.

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --

Why did the Man cry?

He sat there, with his broad shoulders and chiseled jaw. Looking like he could rearrange someone's face with his fist without a moment of hesitation. No doubt bout that, as he used to be a sportsman. One of the 'Heavies', as they call it, those who participate in the Highland games.

He took his seat in the clinic, portraying a strong, confident image. One scowl from him and no doubt anyone would scramble out of his way. I'd looked like a small kid next to him, oh he's tall and big as well. He's so manly, I'm going to refer to him as the Man.

Yet here the Man was, in the Pain Clinic. Why would such a strong person, both physically and the way he portray himself, be here? He could easily take a punch and still manage to send the puncher flying. He looked like someone who will grit his teeth and bear the pain, not someone who come running to others for painkillers. In fact, he did not even attend the last few appointments at the clinic.

So why was he here now?

Well, the Man upped his painkillers by himself so much he almost killed his liver instead. The pain was so frustrating to him, he just wanted to get rid of it no matter what.

So the consultant had to go through his medications, trying to figure out what he had been taking and what could be changed to get on top of the pain.

And then the Man broke down. He sobbed.

--

The consultant gave a very good explanation of what chronic pain is all about. There are three components to it: pain, mood, and suffering. They are never mutually exclusive, one cannot separate one from each other. And everyone responds to chronic pain the same way. They get depressed, even if they do not seem like someone who would let it get to them at all.

If one only treats the pain, he'll be left with the anger, frustration, resentment at his own plight. Just stuff him with antidepressants and make him as happy as larry, he will still feel the pain. Either way, there will still be suffering.

Pain is never one-dimensional. Painkillers will not solve the problem.

--

This is the first time the Man ever cried in front of another guy.

"This isn't like me", the Man said. And you would believe him. "I'm not the kind that gets depressed. I just sail right through it. But underneath it I can feel it boiling, the anger, frustration."

It wasn't the pain that made the Man cry of course.

"I just wanted to do things I used to do."

"I truly understand. But put anyone in your position and he will feel the same. Tell a person in the street you will give him pain 24 hours a day, 7 days a week, 365 days a year, and he will punch you in the face. And then he will feel angry and frustrated. He won't wake up feeling great, feeling able to face another day of pain." The consultant empathises.

"You are someone who will set your goals high and do it. You will do something and ask, 'Why can't I do that?' And that is why the pain will get to you. You will not be able to do things you were able to do in the past. You will feel less of your worth, needing to 'downsize' your job to get a less physical one you can do. It's not easy. I know you felt like you lost yourself."

"What we needed to do, is to bridge the gap between expectations and reality. The pain will never go away. I'm sorry to say that it's the harsh truth."

It was the prospect of living the rest of his life with the pain and the disability it brings.

"There is no point setting unattainable goals, because you will never reach it. But start slow and work your way up. You are not going to be hurling anvils anytime soon."

"I'm not even bothered to do that now," the Man laughed.

"Yes, that will just break you. So start with throwing matchsticks. I can do it, you can do it. I know it sounds pathetic but you have to start somewhere. Then move up, a matchbox, a twig. Get to know your limits. Expand what you can do. And I'm not saying you won't be able to do some things in the future. You can still achieve those goals. It's just not what you do."

"It's how you do it," the Man agreed, wiping his tears.

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --

No one would deny that people with chronic diseases like cancer do suffer. But when it comes to pain, most people just brush it off. It's something you're expected to grit your teeth and pull through. It's easy to downplay the suffering of someone with chronic pain, not knowing how debilitating it can be. How much suffering it can actually cause.

Today, I learned that the pain specialist's most powerful repertoire is not his pills and injections. It's the words he spoke.

Hopefully, the consultant anaesthetist had managed to change this man's mindset in coping with chronic pain. To live with chronic pain, instead of resenting it.

And I was left with awe. He changed someone's life, before even doing anything to his pain. You know the moment when you look at someone, and you just want to be like him/her when you grow up?

I just had that moment (:

The S word - Part I

There's always that uneasy feeling among the bystanders when suicide happened. It's a rather awkward, morbid phenomenon to encounter and most people just don't know what to do. All they can think of are questions. Why? Why? Why?

During routine anaesthetic work in the theatre, a man was rushed into the A&E downstairs after being found unconscious. Very hypothermic, unresponsive, with empty boxes of medication nearby and sheets of information on drug overdose printed off the internet. Almost went into cardiorespiratory arrest, and CPR was done all the way from being found to being resuscitated in the A&E. I followed the anaesthetist consultant down to see the poorly guy, with dozens of people already buzzing around him.

Venflons, pulse oximetry, CVP, arterial line, ETT, NG tube, gastric lavage, peritoneal lavage, urinary catheter, temp probes. Nurses, doctors, students rush about compressing his chest, ventilating his lungs, putting up fluids, drawing up drugs, taking off bloods. All the hospital staff could do to salvage what they could from this man.

Even when he must have thought there's nothing to salvage from his life anymore.

It's baffling, isn't it, why some people chose to end their lives as the solution. Of course, the hospital staff's job is to save his life and not wonder why. Eventually he stabilised, although remained unresponsive to pain. Non-reactive dilated pupils.

It was thought he could have been brain dead already, with only the machines keeping him alive. He was then arranged for a transfer to the nearest ICU in another hospital, hours away. As the emergency passed, everyone eventually left the room to resume their daily routine in other parts of the hospital, entrusting the anaesthetic team to look after him.

Just as quickly as the room was filled with activity, it suddenly became calm and peaceful, with just the monitors beeping away the patient's vitals. I went in to check on the various tubes connected to the patient, and that was when I saw something that broke my heart.

On the back of his hand, he had written with a pen.

Love
you
Mum
I'm sorry

I stopped there for a minute and just stared at the writing on his hand. All I could think of is just one thing. One question.

Why?

I pulled back his eyelids and stared into the distant eyes. No response at all.

Why?

the other world

Last weekend, I did something I've never done before. Something I guess I'd regret if I hadn't done it.

I went to watch a play, all by myself.

It was a couple of weeks ago, while I was walking across town to get my badly-needed haircut when I came across this advert poster showing a new play coming to the local repertory theatre. Intrigued, to say the least, and curious I was. 18 months I've been here in this small Scottish town and I have never really explored all it has to offer. The play would have been a perfect excuse for me to get out of my usual routine and indulge myself in something totally different.

Truth be told, I'm jaded with my life. Since young, I've been prodded towards the Science stream, having school results 'above average'. All my life I've only known a world of numbers and physic laws and chemical bonds. Now, having my path in life already set out in front of me, at times I wondered what it was like if everything had been different.

I'm intrigued, and curious. Of a whole different world I have never experienced. Will probably never know what it's like to be in.

The world of Arts.

That was why I decided to watch that play, actually. Even though it meant that I'll have to go by myself, since I can't think of anyone around who would share that same interest, that same curiosity and sense of intrigue.

That play was Equus. Yes, the same story involving horses and a certain Harry Potter star being nude. Honestly, that piece of gossip absolutely undermined the real quality of the play itself. It deserved far more than being known as 'the play Daniel Radcliffe acted nude in'. The story was highly disturbing. Thought-provoking. And absolutely captivating.

Not to spoil the story, it was about a psychiatrist called in to help a young boy who had a certain 'abnormal' passion with horses. From the start to finish, it was like I was watching the real story unfold itself in front of me. Two and a half hours, I sat there transfixed. I cried. I laughed. I jumped off my seat. The play was that good.

My compliments go to the everyone involved in the play. The direction, acting, lighting, sound effects, were all perfect. For a small-ish repertory theatre (compared to the likes of Edinburgh and Glasgow), it was very professionally done and directed. Forget the Hollywood special effects and explosions and corny lines. This is the real entertainment, as it was centuries and centuries ago.

I guess people indulge in different things in life. Chocolate, alcohol, food, sports cars. I have no interest in any of that. I indulge in the world of arts. The world that has always intrigued me. Kept me curious.

Or perhaps I was just jaded and wanted to escape this life into another world.

seriously cereus

Oh I finally found the secret to losing weight now..

It's called 'Bacillus cereus'.

Just cook your rice and leave it outside in the kitchen for 2 days, then cook it for dinner afterwards. Perfect incubation habitat for multiplying, toxins-releasing bacillus.

No need for any laxatives or appetite suppressant pills.

Bacillus cereus works wonder for your guts. And appetite.

Who says losing weight was hard? :P

(okay I was a little dumb to have thought this freaking cold weather could refrigerate my rice out of the fridge)

--

Anyway wanted to post a 'proper', 'obligatory' New Year post but somehow just couldn't find the time at the moment (in between sitting on the toilet bowl or sleeping in bed all weekend). Starting my second week in the Breast Ward tomorrow, which is very unexciting to say the least.

Another 2 case discussions, 2 mini-CEX, 1 observed practical procedure, 1 Cleanliness Champions module (oh save my soul), and a Ward Simulation Exercise this month. I had been all geared up for the new year, but right now I just can't be bothered.

I need some motivation.

NOT Bacillus cereus.

2010 - turning point in life?

At times, life seems to pass by at a frighteningly fast speed.

On our way back from London city to Luton airport by bus now. Within hours, the five of us - ben, Jackie, mus, cheemei, me - will find ourselves shivering together in the cold of Edinburgh again.

The past 2 days in London must have been the best time I've had in a very long time, felt like forever. Meeting our 3 friends from different parts of the world after so long, it's like nothing has changed. The joking around, the poking fun at each other. Have we really spent any time apart? (:

Last night we talked bout the future. How UK did not felt like home, probably never will. For me, this is as close to home I could feel. With my friends. They are the only place I ever felt I belong. The lot of us in UK were lucky, a big part of the 'family' came here. I was lucky.

However not many of us would still be here in a few years I guess. Even in Dundee only 3 of us chose to stay in Dundee for our foundation years. I admit I'm afraid of graduating, to be in charge of real patients with my seemingly limited knowledge. Yet, for me a future without these friends is even more scary. Now when I look to the future, when we all have graduated and started working, when those who wants to go back has gone back, I'm not sure what there will be to look forward to. These occassional 'family' outings are my only source of strength to maintain my sanity.

Cherish every moment I guess. Ah, we're all growing up, growing old too fast. 6 months to graduation, hopefully.

- posted by iPhone

Oh, Happy New Year 2010 everyone (: