Sanctuary

2009-11-15T00:25:00.003+11:00

So it came, and went - in quick succession. We are in the midst of our finals, and with one more to go....one can't help but yearn for this to be over pronto.

As for the cases themselves? The first day was an absolute shocker. I got hit - pretty hard in the nuts, to be honest - from the start. It did not help too that I knew the examiner, and the examiner remembered me (from my Sem8/9 days)..... I felt awful at the end of my 9-minute station - I think I've let my consultant down. =( The other four stations were just as bad too, but I guess it could have been much worse. At least I still remembered benign positional vertigo (BPV). And how to teach an asthmatic to use his MDI properly.

The second day was a nice change. The short cases we had were thankfully more straight-forward, and the examiners were really nice. A pleasant surprise! =)

Another three more days to go before long case exams, and already I'm left wondering how to prepare for this one. Well I could study EVERYTHING, since anything could potentially be a long case study....truth to be told however, I can't finish everything within three days, and I'm quite sick of revising already. =\

I wish I could end this entry on a more positive note, but given it's past 1am as I typed this.... it's obvious I need some sleep first. So I bid you goodnight - for now. =)

2009-11-08T16:20:00.004+11:00

Min-chan has already left for KL this afternoon..... and my current residence has never been this quiet in a loooong time. Much as I like to think I could study (even) more under such circumstances and not worry about her on a daily basis (=P), the truth is I'm getting real sad that she's not around for company (!!!).

[Note: YOU FEELING FLATTERED NOW, MIN-CHAN?! =P]

Oh well. I'll see my "one-heck-of-a-noisy" sister in a month.....provided everything goes well in the next 2-4 weeks (exam and graduation-wise). Till then, I'm gonna miss Min-chan (minus her random singing! lol.)

2009-10-31T23:53:00.003+11:00

Music, when soft voices die

- Percy Bysshe Shelley-

Music, when soft voices die,
Vibrates in the memory,
Odours, when sweet violets sicken,
Live within the sense they quicken.

Rose leaves, when the rose is dead,
Are heaped for the beloved's bed;
And so thy thoughts, when thou art gone,
Love itself shall slumber on.

2009-10-26T17:42:00.004+11:00

......and my little old lady's feeling much better this morning! XD She gave us the thumbs-up when we arrived, and even went so far claiming that she wants to cease oxygen therapy immediately and start mobilising with her Gutter frame! LOL.

I love this gutsy woman. Seriously. ^_^

2009-10-25T23:02:00.003+11:00

Was leafing through my CCF notes this morning when I was reminded of an 80-year old lady, who went into APO during our round two days ago. Needless to say it was horrible watching someone gasping in front of you, with her bandaged left hand stretched towards me, eyes wide-opened - pleading.

It is akin to near-drowning, APO....only that one's drowning in one's own pleural fluids. The last I saw her, she was down at ICU on BiPAP, having received IV frusemide, morphine and a nitrate patch, with oxygen sats improving remarkably.

I hope she did well over the weekend. It would be a treat to see her back on our ward tomorrow morning.

2009-10-24T21:49:00.006+11:00

Sigh. The more I know a certain person (or two), the more weary I am of them. "Why so?", you ask. For one, try listening to their incessant gossip on a daily basis, and one can't help but be shocked by their spiteful commentaries. I shall not elaborate on the subject(s) of their conversation - suffice to say they were much too malicious - sensitive, even - to publish here.

A classical case of familiarity breeds animosity? Perhaps. After all, it has been 2 1/2 years since I came to know them (yes, it takes THAT long for me to see them for what they truly are) At this point, I could only brush-off whatever they decide to share with me, and continue with my daily grind. Only 3 more weeks to go, and hopefully I'm done with them then. =\

2009-10-19T23:05:00.005+11:00

Food for thought? =\

Article taken from The Age:
--------------------------------------------
February 'worst month to go to hospital': study

NICK MILLER

October 14, 2009

February is the worst month to go to hospital, a new study at Melbourne’s Alfred Hospital has found, because the influx of new trainee doctors causes the number of medical errors to rise by 40 per cent.

The authors of the study, published today in the British Medical Journal (BMJ), found the rate of ‘‘central and peripheral nerve injury’’ was more than five times as high in the first month as in the rest of the year, and it was three times as likely that a patient would be given inadequate oxygen.

Patients were twice as likely to vomit in the operating theatre as a result of their anaesthetic, and an ‘‘accidental upper airway obstruction’’ was also twice as likely.

Uncontrolled high or low blood pressure was also more common in the first month.

They said hospitals need to improve orientation for new trainees, and provide more supervision during the first few months of the surgical year.

Known as the ‘‘July phenomenon’’ in the northern hemisphere, the trend for a spike in patient safety problems at the start of the training year has been a topic of hot debate: acknowledged anecdotally, but not supported until now by research.

The international team of researchers behind this study examined the rate of ‘‘undesirable events’’ in patients having an anaesthetic procedure carried out by first- to fifth-year trainees at The Alfred.

Surprisingly, the increase in the rate of errors was almost the same no matter which year the trainee was in.

The effect was strongest in the first month after the switch-over, which happens in late January to early February. However, it did not disappear entirely until June.

‘‘Lack of technical skills is not the only mechanism explaining the (error rate),’’ the paper said. ‘‘New trainees, regardless of their level of training, are unfamiliar with their new working environment — for example, hospital rules, location of medical charts and laboratory results, roles of other healthcare providers.

‘‘As a result, breakdown in communication and poor interprofessional interactions ... may result.’’

This phenomenon can damage the community’s faith in hospitals and doctors, say Professor Julie Johnson from the University of New South Wales and Professor Paul Barach from the Utrecht Medical Centre, in an accomanying editorial in the BMJ.

‘‘The patient caregiving units cannot absorb the effects of new personnel at the beginning of a new academic year,’’ they wrote.

‘‘We can no longer ignore the elephants in the room ... such as the July phenomenon, handovers of clinical care, and the association between excessive working hours, sleep deprivation and increased medical errors.’’

They said hospitals should have a slower uptake of responsibilities in the first week of service, avoiding overnight duties. Trainees could start in a staggered timetable, and when patients had complex needs the trainees should be fully supervised.

Dr Xavier Yu, a surgical trainee who has worked at several Melbourne hospitals over the last eight years, said the errors revealed by the research were ‘‘quite basic’’.

‘‘They were probably thrown by the new environment,’’ he said.

‘‘Not knowing where equipment is will prolong an operation. Or if you are not familiar with what equipment is available at a new hospital, you could be forced to improvise.

‘‘You’re not familiar with hospital protocols, so you might not know who has to sign the forms, which consultant to call, who to call to organise an operating theatre. If you are not clued up, you can get potential errors.’’

He said as a trainee he had wished for a "mentor" — a senior doctor who knew the ropes at that hospital, and who could be turned to for independent advice.

Trainees have supervisors who also assess the trainees’ performance, so trainees were reluctant to admit a lack of knowledge to them.

‘‘Hospitals need to allocate resources for mentors who could walk around and check with trainees that everything is ok,’’ Dr Yu said.

‘‘That would really change a lot of things.’’

AMA Victoria’s president Dr Harry Hemley said there were not enough resources devoted to junior doctor training.

‘‘It’s not just a matter of increasing the time allocated to training – we also need better support systems for junior doctors and greater staff flexibility,’’ he said.

“We need to encourage experienced senior doctors stay in the public system so that they can teach and supervise the next generation of doctors.

“The number of medical graduates entering our public hospital system will have doubled by 2013 – training improvements need to begin now. Tomorrow is too late.”

2009-10-16T21:06:00.004+11:00

An elderly man from nursing home was admitted under my team 2 1/2 weeks ago for delirium secondary to UTI, with a background Hx of Parkinson's Disease, ?demetia, IHD and Type 2-DM. He also has a permanent IDC, presumably for chronic urinary retention. As expected, his cognitive state fluctuated on a daily basis for two weeks. At best, he was orientated to person, time and (somewhat) to place - at his worst, he was aggressive, as typified by throwing his breakfast cereal at nurses, accusing medical staff for "imprisoning" him against his will, and on numerous occasions tugged at his IDC - with the latter being a constant source of grief for all involved in his care.

Many a time we found him fiddling at the catheter, and the bag draining blood-stained urine. And many a time, we managed to get it back under control. None however was as bad as the latest episode this morning, when he pulled his cathether (again), got his IDC blocked presumably from a blood clot, went into acute urinary retention, and was rushed down to ED for a suprapubic catheterization. At 2am. All initially went well after 1.5L urine was drained from the bladder, and the urine bag was subsequently draining clear fluid.

The crunch came when my medical team did the usual morning WR. We found him in his chair, incoherent, sheet-white, with bag draining frank blood. Systolic BP was around 75, and urgent FBE returned with Hb dramatically dropped from a relatively low 80-87 to 45.

The last I saw him? He was being transfused 4 units of packed RBCs. I do not know the outcome of his situation, given I got called away for tutorials (at two different hospitals), and never had the opportunity to return.

First off, I hope he came through OK. Secondly, I wonder if there is anything else we could have done to prevent that in the first place. The IDC, I feel, was the main problem. With him having a permanent IDC, he is always at risk of UTIs (which then predisposes him to delirium, the constant pulling *sigh*, and the inevitable meatal trauma/bleed). However, if one decides to take the cathether out, he then goes into acute urinary retention, which causes discomfort/pain (and that also happens to exacerbate/trigger delirium)......

*sigh* *sigh* *SIGH*

Any thoughts on this, anyone? =\

2009-10-14T17:56:00.010+11:00

Presenting Jon Schmidt - an American, "New Age Classical" pianist with a flair of combining contemporary pieces, as depicted in the following arrangement. Hope you enjoy his music as much as I did when I saw this video. =)

Love Story (Taylor Swift) meets Vida la Vida (Coldplay)

2009-10-13T16:04:00.002+11:00

One young nurse mistook me for a medical registrar this afternoon. *instant haematemesis*

Thank you, dear....I feel so much older now. (T_T)

2009-10-12T23:04:00.004+11:00

There's nothing worse for me today than the aftermath of a Mantoux skin test - the initial enlarging bump, the surrounding warm, erythematous skin.....and THAT FREAKIN' ITCH!!!! OMG, THAT NEARLY KILLED ME!!!!!

2009-08-06T21:03:00.002+10:00

A really, really hilarious letter.....tenderly ripped from a forwarded email. =P

LETTER OF RECOMMENDATION

1 Trevor Adams, my assistant programmer, can always be found
2 hard at work in his cubicle. Trevor works independently, without
3 wasting company time talking to colleagues. Trevor never
4 thinks twice about assisting fellow employees, and he always
5 finishes given assignments on time. Often he takes extended
6 measures to complete his work, sometimes skipping coffee
7 breaks. Trevor is a dedicated individual who has absolutely no
8 vanity in spite of his high accomplishments and profound
9 knowledge in his field. I firmly believe that Trevor can be
10 classed as a high-calibre employee, the type that cannot be
11 dispensed with. Consequently, I truly recommend that Trevor be
12 promoted to executive management, and a proposal will be
13 executed as soon as possible.

Addendum
The idiot was standing over my shoulder while I wrote this report.
Kindly re-read only the odd numbered lines.

2009-07-20T10:58:00.005+10:00

It took me a long while before everything sank in. In disbelief I checked, rechecked.... and triple-checked my match results on PMCV this morning. I was offered an internship position at the Royal Melbourne Hospital (RMH). How could that be? The competition was so intense (apparently 600+ applicants this year), I thought I didn't stand a chance.....

Kathy Sharpp confirmed the news less than an hour later, congratulating me on the match and informed that I will receive the employment contract in a few days. [really efficient crew, I have to admit!!!]

Over the next 1 hour, I have been refreshing my FB account - amused and ecstatic to see many fellow medics online, sharing good news within our network. I am very happy for them all, seeing it has been a rather pleasant outcome. =)

I wonder now how my fellow IMU colleagues have been doing. So far I am only aware both Manjeet and Matt were matched to their first choices (StV and Eastern respectively). Hope everyone else did well, and got what they wanted.

On another sidenote, an internship at RMH would certainly be intense, and not forgetting stressful too. Looking forward to it now though. XD

2009-07-13T18:40:00.002+10:00

Baked an apple crumble the other night with Min. It turned out alright, although I should cook the apples a little longer....and perhaps switch all Granny Smiths to Golden Delicious the next time round! LOL.

On a side-note, it looked pretty good on camera with vanilla ice-cream and fresh strawberries, no? =P

2009-07-10T17:18:00.009+10:00

This movie certainly saved me from another mundane evening! =) Based on Neil Gailman's novella, it tells the tale of 11-year old Coraline Jones and the events that ensued after she moved into the Pink Palace Apartment with her parents.

The plot may be (relatively) simple to a few people. Nevertheless I found it quite compelling - even a little eerie, to some effect. Below is a synopsis of the movie, which I've lovingly "ripped" from Wiki:

Coraline Jones moves into the Pink Palace Apartments with her loving but preoccupied and work-consumed mother and father. Bored and seemingly neglected, Coraline explores the house and premises where she meets her eccentric neighbors: Wybie Lovat, an odd boy who tends to a stray black cat; Misses Spink and Forcible, a pair of long-retired actresses who have taken up fortune-telling; and Mr. Bobinsky, a tall Russian acrobat supposedly training a circus of mice. During her exploration, Coraline comes across a small, bricked up door in her apartment. Awakened that night by a "jumping mouse," Coraline follows it to discover a dark passage now extending beyond the door, which leads her to an alternate version of the house in a place called the Other World. There she meets two beings who introduce themselves as her "Other Mother" and "Other Father," surreally pleasant and interesting doubles of her real parents with buttons for eyes. Coraline is guided through the Other World, which proves to be more colourful and enjoyable than her old home....

Coraline reminded me of "Little Big Planet" in many ways (which incidentally is also the only PS3 game I WOULD play so far =P), especially in the alternate world where the characters are more doll-like. Very beautifully crafted, in my opinion. AND WHAT MUSIC!!!! The scores are haunting, and simply fitting for the overall theme.

Do give Coraline a shot. Please? XD

2009-07-08T11:28:00.006+10:00

Funny, to think I'm now so bored just 5 days into my holidays! LOL. Guess it's because of the cold I caught 2 days after exams - didn't feel like venturing out in the open that much, despite relatively fine weather forecasts. =P Thankfully feeling much better now, and am really looking forward to luncheons with friends!

At long last, my internship interviews have come to an end. *phew* It has been a very nerve-wrecking month, with group interviews being the worst of the lot. Preparing and reciting a 5-minute monologue (which is basically a self-marketing piece) isn't quite my cup of tea!! ><" I'm trained to be a medical doctor, not a marketing agent dammit!!!! I'm relieved it's over though, and now keeping my fingers crossed for the 20th July (2-week period) national internship offer. =\

Am currently on the lookout for something to keep myself occupied during this term break.... any great ideas? Have always wanted to try out archery, for some unknown reason. Heh. Is there a good archery centre in Melbourne, anyone??!! Heard from Carlie there used to be one in Melbourne, but that went up in smoke - literally. The centre burnt down a couple of years back. (-_-")

Oh before I forget - To all anime-fans in Melbourne, great news: AnimeFest is BACK!!! *yay!* Do check their website for more information yea. Website as follows: www.manifest.org.au.

2009-07-03T14:22:00.003+10:00

This is what I am currently feeling now, post-exams. ><" But don't fret - give me a few hours to blow off steam, and hopefully I'll be fine by evening. Heh.

O&G has been.... a rather mix bag for me, to be honest. Sure I've met a few wonderful people at the Women's, and there were rather interesting episodes while I was at the birthing suite, but I think a one-off experience in O&G is enough for me!!! LOL.

2009-06-01T18:45:00.001+10:00

I'm taking an "extended leave" from blogging - well at least until my whirlwind of exams, violin recital, health-checks and internship applications/interviews are done with. =P

Will be back after 3rd July. At the meantime, I need all the luck I can get!!!! ><"

2009-05-19T21:41:00.003+10:00

This pic sums up my overall thoughts of O&G really nicely, so I figured I'll just paste it here rather than spending the next 14 days (yes it will take that long) complaining on this blog. ><"

O&G's seriously driving me insane. I absolutely hate it.

2009-05-10T20:27:00.003+10:00

OMG OMG OMG I'VE GAINED 5 KILOS SINCE FEB THIS YEAR!!!!!!!!!!!!!! WHAT HAVE I DONE???? MORE IMPORTANTLY WHAT ON EARTH HAVE I BEEN EATING ALL THIS WHILE???!!!!!!!

*sniffs*

2009-05-02T23:10:00.004+10:00

Yuen turns 24 today!

A relatively quiet affair today, despite being inundated with birthday wishes from fellow friends, colleagues and family all through the day, a couple of well-meaning (and much appreciated!) prezzies from Min, Uncle Hong & Ping, and a surprise phone call which resulted in dinner with some friends. Hahaha. So to all my well-wishers, thank you once again for making my day. =)

2009-04-22T23:55:00.002+10:00

Me at this point in time:

I hate exams - they stress me out, no matter minute they might be. ><"

2009-04-16T14:26:00.004+10:00

GOOD GOD. WHY ARE WE EXPECTED TO DEVOUR AT LEAST 25-ODD SETS OF O&G LECTURES WITHIN 4 1/2 FREAKING DAYS BEFORE A "DEFINITIONS EXAM" THAT WOULD CONTRIBUTE A MEGRE 4% OF OUR OVERALL MARK???!!!!!!!!!!!!!!

THAT IS INSANE.

AND PROFOUNDLY SADISTIC.

Hell is drawing near. I can smell it.

2009-04-15T17:41:00.003+10:00

Finding referees for my assessment form is a lot harder than I thought.

Given that the majority of our medical/surgical rotations change every 6 weeks, compounded with the fact that we are not attached to a particular consultant/fellow/any senior doctor everyday for 6 weeks, they can't really gauge how much we know clinically now, can they? =(

It's true I've worked with many doctors in the past, and it's also true that I "kick off" well with a few by the end of my posting, but tell me this - how much can they remember 3 months down the line, what more 2 years later....especially when they've taught a stream of junior doctors and students after me?

In a way I'm thankful we now have to nominate 2 referees instead of 3 this year, but that also means I have to choose very carefully.... it all hangs so precariously by the thread at the moment, and I don't want to jeopardize everything.

About 6 more weeks to go. So much to do, so little time.

Sigh.

2009-04-04T09:42:00.006+11:00

It was just like any other evening shift at ED-RCH, with me shadowing a Canadian ED physician (who resembled RMH-WH haematologist Dr. Renwick!). We went into resus, after being informed about a 12-month old girl who pulled down a hot, metal water jug on herself, sustaining splash scalds on her forehead, upper trunk, left upper limb and feet. And there she was, looking miserable and wrapped in her mother's arms, with two nurses and a play therapist by their side.

As the little bub turned to look at us when we approached, she started to fret and cry....

Now one would naturally think that was usual, to have unwell/anxious children crying in ED. But our play therapist noticed a pattern with this child's anxiety - whenever the doctor and I approached her (within her view) she'll bawl her lungs out; she was otherwise alright with other staff members.

When the ED physician left us for a bit, the play therapist decided to test her hypothesis by asking me to take my glasses off.

Somewhat puzzled by her request, I nevertheless did what I was told. She then hid my pair away from the bub, and who would have thought - the child immediately stopped crying!!

Amused, the play therapist then began asking the mother if there's anyone who wears glasses at home. She nodded, explaining that the child's grandmother (who lives with them) is the only one in their family who wore glasses, and that she has been quite strict with the little girl....

No wonder the "12-monther" was 'frightened' when she saw both of us (ie: doctor and I). We were the only ones who wore glasses at that time, and our specs somehow reminded her of her grandmother!!!

LOL.

2009-03-28T23:08:00.007+11:00

It seems that I'm picking up one respiratory bug after another at RCH, no matter how often I religiously de-bug with microshield. ><" I guess it cannot be helped, given I'm currently in a huge pool of relatively active kids with loads of love (and microbes) to share. However, I can contend with the fact that since I've been exposed to a cesspool of bugs within a short span of time, I'm buffing my immune system up for the winter!!! =P

But I must admit, working with children is more fun than I thought. Especially with the younger ones - they don't complain much, are usually bubbly (unless they're terribly ill), and when they do get better, they recover really quick. Also, people would HARDLY reprimand you for being childish/disinhibited in front of kids, which is an added bonus. =P

Two more weeks to go, and I'm dreading it will soon end already..... =(

Now I understand why Dad went into paediatrics in the first place. Paeds may be a world's away from adult medicine, but I'm loving every moment of it.

2009-03-20T00:07:00.007+11:00

Ah, doesn't this bub look so satisfied with her baby formula? =P

We had a nutrition tutorial this morning with a paediatric dietition down at the Royal Children's Hospital (ie: my current base till next rotation). It was an interesting session in general, but the highlight of the day was actually sampling a few infant milk formulas (as prepared by the dietition herself)......

By doing so she aims to get a few points across by requesting us to:

1. First imagine a baby being on a type of formula milk for at least 6 whole months - which essentially means thriving on one TASTE during that interim.

2. Then imagine introducing different types of food to a child from 6 months onwards - more choices, a wide variety of taste, textures and colours.

At the end of that tute, we had the following to sample:

1. S26 (a cows' milk based formula)

2. Soy-based formula

3. Pepti Junior (a partially hydrolyzed formula)

Needless to say, we (unanimously) came down to this verdict:

Out of the three, S26 was the most palatable. I suppose that was not surprising, given that it IS cows' milk formula (and therefore the taste is quite similar to fresh cow's milk, obviously!)

The other two had mixed reviews however - some didn't mind the soy formula so much, although I personally felt that was the most disgusting-tasting milk I've ever had! (Pepti Junior came a close second)

Our dear dietition made an interesting comment at the end though: She said the taste of breast-milk varies according to the lactating mother's diet, and therefore babies who are exclusively breast-fed do have a variety of taste to sample from. What's even more intriguing is the fact that perhaps because of this, studies have also shown that exclusively breast-fed babies are usually more open to experimenting/trying new foods later in life...... =)

So there you have it - another one more reason to advocate breast-feeding!

2009-03-14T11:07:00.004+11:00

Was over the moon when my PBL-cum-clinical tutor commented I was well-versed in paediatrics during a mid-rotation formative feedback yesterday. It was quite surreal actually, to have a Fellow saying that knowledge-wise, I am almost at the level of a paediatrician(!!). My only flaw, she quipped, was perhaps my modesty and lack of confidence in my own strength(s).... so my "homework" for the remaining 4 weeks is to get out there, see as many children as possible and consolidate everything in clinical settings.

Given that I'm still quite afraid of unwell/unhappy children with equally unhappy/tired/anxious parents (seriously!), that was a timely morale boost for me!!!! =P

2009-03-08T21:55:00.003+11:00

Yeap, I (finally) decided to register for the 5.7km route on Sunday, 5th April 2009 in conjunction with the Good Friday Appeal. ^_^

My endurance level isn't what it used to be though, so training was a little difficult to get used to initially. Two weeks (4 days, to be precise) into training with a team of marathon 'veterans' can be both grueling (My current stamina couldn't even match Jack, Trudi's two-year old toy poodle which she took for a 4.0km training session this morning!) and enjoyable (great view at the Royal Botanical Gardens) at the same time. =P

Sure I still get those sore legs post-run, but they aren't as bad as the week before (could barely climb up the stairs at RCH and sit down properly!!!).

[Note: My trusty mate at the mo - Dencorub Heat Gel with salicylate. Heaven-sent. =P]

Anyhow, 27 more days to go before the run, so gotta get up and moving! ^_^ Besides, I can't keep losing to Jack the poodle all the time now, can I?

2009-02-18T20:44:00.040+11:00

Hell On Earth

View of Yering Station & Chateau Yering, Victoria.

En route to Melbourne two Saturdays ago, a young Iranian passenger nudged me in the elbow and pointed at something from afar. A wisp of white smoke, I noted as we peered out of the aircraft window. We've heard of sporadic bushfires in hot, dry Victoria recently, so we simply thought, "Must be another one of those fires."

A bushfire burns in the Bunyip State Forest near the township of Tonimbuk. Picture: AAP/Andrew Brownbill

Little did we know then of Mother Nature's fury. Fires raged throughout that night in numerous "hotspots", sweeping across counties at terrifying speed.

Cliche as it may sound to many, I still believe that a picture paints a thousand words. As such, I'd like to share a number of photographs taken by Herald Sun's photographers, which captured the essence of what is now known as Black Saturday in Australian history: the devastation that literally brought townships down to ashes and blackened rubble, the lives lost, the people who fought the fires relentlessly, the survivors, volunteers who graciously helped the bushfire victims, and the resilience of so many Victorian communities in the aftermath.

A smoke cloud approaches Labertouche, near Pakenham, east of Melbourne. Picture: Alex Coppel

King Lake and surrounds from Everton Stud Eden Park. Picture: Chris Sheffield

Brian Kelly fights the fires overnight with his family and friends to save his Kilmore East property. Picture: Nicole Garmston

CFA fire fighter from the Gapsted crew moves into position fighting a scrub fire on property off Blacks Flat Road near Beechworth. Picture: David Caird

CFA firefighters prepare for another day at the fires. Picture: Norm Oorloff

The last I've heard, they managed to contain over 115 Victorian bushfires in a span of two weeks. Four large fires are currently still out of control due to strong, erratic winds and inaccessible terrains.

Meltdown - the intensity of the fires must have been unimaginable. Picture:Craig Borrow

The devastated township of Kinglake. Picture: Mark Smith/ Courtesy of Channel 10 helicopter

No more than blackened matchsticks - An aerial shot of burnt trees. Picture: Mark Smith

Firefighters from South Australia rest in a school bus shelter after battling the fires at Callignee. Picture: Peter Ward

At the Whittlesea relief centre - Andrew Barber and his nephew Deakin Criggie, 15 months old, have lost their house in Pheasant Creek. Andrew, 18, fought the fires all yesterday and dropped by the relief centre for a break and some love. Picture: Fiona Hamilton

Peter and Wendy Crooks used almost 40 cans of cola to put out fires in the eaves after their pump failed. They saved their Kinglake home. Picture: Trevor Pinder.

Jason Lynn, a neighbour of deceased newsman Brian Naylor, survived by lying in mud when fires surrounded his property at Kinglake. A minister gave him last rites on a mobile phone minutes before a CFA member found him, semi-conscious and only just breathing. Picture: Fiona Hamilton

Aaron Robertson from the Kinglake CFA stands in the ruins of his house. He was down in St Andrews fighting fires when Kinglake was hit. He and the crew that he was with saved a number of houses in St Andrews. Picture: Jon Hargest

CFA volunteer David Tree helps a distressed koala in burnt-out forest at Mirboo North. Pic: Russell Vickery

Ruth Lynn, who lost everything at Pheasant Creek, had to leave her dogs when she escaped. She later discovered her dog Bruno burnt and on a drip but alive at the animal shelter. Picture: Fiona Hamilton

Helen Clover (right) and Claire Ellt are neighbours from Kinglake West who believed each other to be dead. Picture: Fiona Hamilton

Forensic investigators comb through a building in Marysville in search of victims. Picture: Mark Smith/ courtesy of Channel 10 helicopter.

Michael Walsh (front) is told by his father Dan that his mother Marie died in fire at the Cumberland Spa Resort in Marysville. Picture: Norm Oorloff

The death toll has now jumped from 201 to 209, with the five worst hit towns being: Marysville, Strathewen, King Lake, St. Andrews and Steels Creek.

People affected by the bushfires slept in their cars and the community centre of Healesville. Picture: Craig Borrow

People check and add details on the community notice board at the Whittlesea relief centre. Picture: Fiona Hamilton

The Kinglake Harvest Cafe has been transformed into a supply depot to furnish locals with all the supplies they need. Picture: Bruce Long

Grace Wilson, the daughter of John and Sue Wilson who died in their house at Mudgegonga, holds a garden sunflower she salvaged from the house. Picture: Renee Nowytarger.

A flora tribute at a destroyed home in Pheasant Creek, where a mother and her three children perished. Picture: Fiona Hamilton

Rosa Chahaine is finally reunited with her 74-year-old father Cocerale Chahaine who stayed in Kinglake West alone to save his house. He lost all but a handful of his stock and has lived on eggs from his two chooks and beer for the past three days before he was able to get out to get supplies and to hug his daughter. Picture: Fiona Hamilton

A sign of hope and determination hangs on the fence outside a Pheasant Creek home. Picture: Fiona Hamilton

To the people whose lives have been afflicted by the bushfire tragedy - no words could describe what you've endured in the past two weeks, nor could they ever take your pain and loss away. My heartfelt condolences to all.

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More on the Victorian bushfires:

Victorian Fire Threat High This Weekend, Herald Sun

2009-02-08T21:28:00.001+11:00

The Dante's Inferno Test has sent you to Purgatory!
Here is how you matched up against all the levels:

Level	Score
Purgatory (Repenting Believers)	High
Level 1 - Limbo (Virtuous Non-Believers)	High
Level 2 (Lustful)	Low
Level 3 (Gluttonous)	Moderate
Level 4 (Prodigal and Avaricious)	Low
Level 5 (Wrathful and Gloomy)	Low
Level 6 - The City of Dis (Heretics)	Very Low
Level 7 (Violent)	Low
Level 8- the Malebolge (Fraudulent, Malicious, Panderers)	Moderate
Level 9 - Cocytus (Treacherous)	Low

Take the Dante's" Divine Comedy Inferno Test

2009-01-25T03:18:00.002+11:00

Going back to Teluk Intan (Perak) within 6 hours to usher in the New Year, so will be on a 2-day hiatus. =P To all my fellow Chinese friends, "Xin Nian Kuai Le". To the rest of the clan, happy holidays!!! XD

2009-01-22T17:39:00.004+11:00

"Boom de yada" Song.

Something worth smiling about. XD

2008-12-30T23:16:00.012+11:00

Mamma Mia was awesome!!!!

No, I'm not harping about the movie version despite a star-studded cast. In fact, I didn't even last 15 minutes into the movie. Why? They are NOT specifically trained for Broadway, so no surprises what the outcome would be. =P

This one, I have to say, struck the jackpot. =) When revealed that Mamma Mia The Musical is finally performing in Malaysia between 17 Dec 08 - 1 Jan 09, Dad quickly jumped at the opportunity, securing 5 tickets for the 27th Dec play. The seats were pretty on the ex side, but for such an astounding show....it was worth the expenses. XD

As for the story, it is essentially about a young girl's quest to discover who her biological father is. One thing led to another when she found her mother's diary, resulting in three potential Dads arriving on site. The end-results were nothing short of hilarious and heart-felt.

A portion of the international crew that performed in Kuala Lumpur recently. Taken from TheStar, by the way. Unfortunately this is also the ONLY picture I have of the crew. =( So to make up for the "loss", subsequent pics are of the London troupe. =P (The backdrops, costumes and choreography are similar anyway!!!) Pics taken from www.mamma-mia.com:

The mother of the bride and her two besties, belting out Super Trooper.

The three Dads upon arrival. No prizes for guessing who the Aussie is.... =P

The bride-to-be and her gals, on hens' night.

The groom and boys, all (almost) ready to fish some pearls.

One amazing piece of work mid-air. The fellow (on night of the KL musical) simply jumped from the ground and did this 180 degree split, without breaking a sweat. Thankfully his shorts weren't too tight. =P

All in all, a great show. Makes me wanna slip into some 1970's hotpants and do the boogie big time...

(Pic courtesy of www.abroath.blogspot.com)

.... *blinks* On second thought, maybe not. =P

2008-12-26T01:09:00.002+11:00

MERRY CHRISTMAS peeps!!! And have a HAPPY NEW YEAR!!! XD

My apologies for the rather sluggish update. Connection back home has been....slow. =P Will post a few things up over the next few days or so. Hehehe.

2008-12-13T10:02:00.001+11:00

I'm coming home.

2008-12-11T17:28:00.004+11:00

Success!! Donated blood for the first time! haha. Wasn't as bad as I expected too. And best of all, I might get to help someone this Christmas. =)

Sure beats giving prezzies anytime.

2008-12-09T21:39:00.005+11:00

A Mother's Love.

So she died.

Dr. Yogeswari, 40, a veterinarian, mother of three children, and my father's friend - was one of the four who perished in Bukit Antarabangsa's latest calamity. She reportedly rushed back into her house after discovering her son was still inside. There she found the boy, and used her body to protect him from a falling beam....

She bled to death. But she died while trying to save her son's life.

Dr. Yoges, may your soul rest in peace.

2008-12-06T22:51:00.010+11:00

Massive landslide in Bukit Antarabangsa

-bernama-

[Exerpt taken from http://www.nst.com.my/]

KUALA LUMPUR, Sat:

Four people were killed and more than eight others are feared buried in a landslide early today in Bukit Antarabangsa, Hulu Klang, near here. The landslide, which is believed to have buried 14 bungalows in Taman Bukit Mewah and Taman Bukit Utama, occurred at about 4am.

Three of the four killed are women, according to Red Crescent personnel at the scene. About 15 injured people have been sent to Kuala Lumpur Hospital.The landslide has cut off the access road to the residential area, trapping hundreds of people at Bukit Antarabangsa. Eight of the bungalows affected are in Taman Bukit Utama and the other six in Taman Bukit Mewah, said a spokesman of the Fire and Rescue Unit at the scene.One of the bungalows is believed to be owned by Datuk Mohamed Thajudeen Abdul Wahab, the principal private secretary to the prime minister.

A search and rescue operation has been launched, involving personnel from the military, Civil Defence Department, Special Malaysia Disaster Assistance and Rescue (Smart) team, Fire & Rescue Unit and Ampang Jaya Municipal Council. The injured were given first aid at the Addinniah surau before being sent to the nearest hospitals in ambulances, at least 12 of which were seen at the scene. Bukit Antarabangsa State Assemblyman Azmin Ali said at the scene that earth movement continued to take place and that electricity supply to several housing estates in Bukit Antarabangsa was disrupted.

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

To the uninitiated, Bukit Antarabangsa (or "International Hill" for the non-Malaysians) is one of those places situated atop the hills in Hulu Kelang, Ampang. There it boasts several affluent housing estates, a rather breath-taking view of the city.....

A Balinese-inspired bungalow at Bukit Antarabangsa. Yours for *coughs* only RM6.5 million.

[Photo from http://www.pillaiproperties.com/]

Kuala Lumpur in the evening, as viewed from Bukit Antarabangsa.

.....and a string of landslides, no thanks to widespread deforestation, reckless hillslope development and heavy downpours.

The latest catastrophe occured today at 4am, as mentioned in the article above.

Bird's eye view of the massive landslide at Bukit Antarabangsa

Close-ups of the damage

All that's left of a house

Close-up view of a bungalow

To the rescue - so far 2000 people have been evacuated from vicinity

[Photos of landslides taken from www.thestar.com.my]

A number of my mates lived there when we were still at school. I just hope they are alright. *prays*

2008-11-27T13:43:00.002+11:00

You just gotta watch this. SUPERB!!!! XD

May blog about this during the weekend or so.... meanwhile, I gotta get ready for tute at 3pm. =P

Later!!!

2008-11-22T21:17:00.004+11:00

It's been unusually cold this week in Melbourne.

I found it quite pleasant initially - the cool winds meant there won't be any of those pesky Aussie bushflies in the first place, which is certainly a GOOD thing!!! =P

Yuen's been having second thoughts now though, especially when temperatures are starting to hit a low 11 degrees Celcius. =\ In summer, no less!

Apart from a 30-minute violin lesson at 3.30pm, I was at home most of the day - sheltered from a rather ferocious downpour outdoors. There were even a few bursts of hailstorms in the morning, but it wasn't too bad since they were half the size of peas anyway. Besides, it was nice watching the ice-specks pitter-patter against my window-sill. =)

Hoping for a clearer sky tomorrow. =) In the meantime, back to my books. *groans*

Two more weeks, Yuen. Just hang in there. =P

2008-11-20T19:28:00.005+11:00

We need help.

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

(Taken from Australian Red Cross - Blood Service page):

Low blood stocks new donors needed

17.11.2008

" The Australian Red Cross Blood Service (ARCBS) is urgently calling for new blood donors to come forward in every state and territory.

A severe winter coughs and colds season, combined with continued strong clinical demands, has impacted heavily on Australias blood stocks despite record levels of public blood donation in 2008.

ARCBS continues the gradual task of rebuilding the nations blood stocks to optimum levels, but is now calling on new donors to help in that task.

We are calling for all blood type donors.

A new campaign in the coming weeks will place special emphasis on encouraging 0+ and A+ blood type donors as they are the most common blood groups.

ARCBS urgently requires new donors to expand the existing donor base and help meet the needs of Australians for the remainder of 2008.

We are also encouraging existing donors who have not donated for sometime to come back and make another life-saving donation.... "

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

If you'd like more information regarding the blood donation drive, click here

For potential donors in Melbourne:

You'll need to register (either online or call 13 14 95) and then make an appointment prior. As for the venue, you can check their website for the nearest blood donation centres.

If you're residing in the city, there is a large blood donation centre on Bourke St (add: Level 2, 360 Bourke St., Melbourne). The building is located at the junction of Bourke St and Elizabeth St (where Angus & Robertson's Book Shop is). =)

2008-11-19T22:51:00.007+11:00

I need to stick this article here =P:

From MSN News:

Man tries to pay bill with spider drawing

Below is the complete email conversation that Adelaide man David Thorne claims he had with a utility company chasing payment of an overdue bill.

From: Jane Gilles

Date: Wednesday 8 Oct 2008 12.19pm

To: David Thorne

Subject: Overdue account

Dear David, Our records indicate that your account is overdue by the amount of $233.95. If you have already made this payment please contact us within the next 7 days to confirm payment has been applied to your account and is no longer outstanding.

Yours sincerely, Jane Gilles

From: David Thorne

Date: Wednesday 8 Oct 2008 12.37pm

To: Jane Gilles

Subject: Re: Overdue account

Dear Jane, I do not have any money so am sending you this drawing I did of a spider instead. I value the drawing at $233.95 so trust that this settles the matter.

Regards, David.

From: Jane Gilles

Date: Thursday 9 Oct 2008 10.07am

To: David Thorne

Subject: Overdue account

Dear David, Thank you for contacting us. Unfortunately we are unable to accept drawings as payment and your account remains in arrears of $233.95. Please contact us within the next 7 days to confirm payment has been applied to your account and is no longer outstanding.

Yours sincerely, Jane Gilles

From: David Thorne

Date: Thursday 9 Oct 2008 10.32am

To: Jane Gilles

Subject: Re: Overdue account

Dear Jane, Can I have my drawing of a spider back then please.

Regards, David.

From: Jane Gilles

Date: Thursday 9 Oct 2008 11.42am

To: David Thorne

Subject: Re: Re: Overdue account

Dear David, You emailed the drawing to me. Do you want me to email it back to you?

Yours sincerely, Jane Gilles

From: David Thorne

Date: Thursday 9 Oct 2008 11.56am

To: Jane Gilles

Subject: Re: Re: Re: Overdue account

Dear Jane,

Yes please.

Regards, David.

From: Jane Gilles

Date: Thursday 9 Oct 2008 12.14pm

To: David Thorne

Subject: Re: Re: Re: Re: Overdue account

Attached

From: David Thorne

Date: Friday 10 Oct 2008 09.22am

To: Jane Gilles

Subject: Whose spider is that?

Dear Jane, Are you sure this drawing of a spider is the one I sent you? This spider only has seven legs and I do not feel I would have made such an elementary mistake when I drew it.

Regards, David.

From: Jane Gilles

Date: Friday 10 Oct 2008 11.03am

To: David Thorne

Subject: Re: Whose spider is that?

Dear David, Yes it is the same drawing. I copied and pasted it from the email you sent me on the 8th. David your account is still overdue by the amount of $233.95. Please make this payment as soon as possible.

Yours sincerely, Jane Gilles

From: David Thorne

Date: Friday 10 Oct 2008 11.05am

To: Jane Gilles

Subject: Automated Out of Office Response

Thank you for contacting me. I am currently away on leave, traveling through time and will be returning last week.

Regards, David.

From: David Thorne

Date: Friday 10 Oct 2008 11.08am

To: Jane Gilles

Subject: Re: Re: Whose spider is that?

Hello, I am back and have read through your emails and accept that despite missing a leg, that drawing of a spider may indeed be the one I sent you. I realise with hindsight that it is possible you rejected the drawing of a spider due to this obvious limb ommission but did not point it out in an effort to avoid hurting my feelings. As such, I am sending you a revised drawing with the correct number of legs as full payment for any amount outstanding. I trust this will bring the matter to a conclusion.

Regards, David.

From: Jane Gilles

Date: Monday 13 Oct 2008 2.51pm

To: David Thorne

Subject: Re: Re: Re: Whose spider is that?

Dear David, As I have stated, we do not accept drawings in lei of money for accounts outstanding. We accept cheque, bank cheque, money order or cash. Please make a payment this week to avoid incurring any additional fees.

Yours sincerely, Jane Gilles

From: David Thorne

Date: Monday 13 Oct 2008 3.17pm

To: Jane Gilles

Subject: Re: Re: Re: Re: Whose spider is that?

I understand and will definitely make a payment this week if I remember. As you have not accepted my second drawing as payment, please return the drawing to me as soon as possible. It was silly of me to assume I could provide you with something of completely no value whatsoever, waste your time and then attach such a large amount to it.

Regards, David.

From: Jane Gilles

Date: Tuesday 14 Oct 2008 11.18am

To: David Thorne

Subject: Re: Re: Re: Re: Re: Whose spider is that?

Attached

2008-11-15T18:38:00.006+11:00

Dear Yuen,

It's been six months..... why can't you just forget it and move on? ><"

2008-11-14T22:42:00.010+11:00

For more information regarding Operation Christmas Child, Click Here

May this box brightens a child's day somewhere in SEA/Pacific. XD

It was quite fun filling the shoebox up with Min!! The space was somewhat limited though, since there were simply so many things we wanted to throw in!! LOL.

Anyhow, Min's finally flying home for the summer hols. Man, I wish I could go with her too!!! *sniffs* (I'm sure gonna miss having that little bugger around. =P)

And so, to "celebrate" her last day in Melbourne (well not exactly last, as she's comng back next March....but you know what I mean =P), Min and I decided to do a little baking. Since it was her first time helping me out in the kitchen, the results were nothing short of hilarious. We were like kids in a candy shop - preparing, mixing the ingredients, forming dough, and shaping them into logs, all the while bantering and making one heck of a mess on the table (much to my uncle's angst!) LOL. So far, we've made a batch of hazelnut shortbread - it's my first go at the recipe too, so hopefully they'll turn out fine!!! XD The dough's in the fridge at the mo....will bake them once it's firm.

Love how my fingers currently smell of vanilla, butter and hazelnuts.... ^_^

Will be right back!!

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

Few hours later.....

66% success rate (coz I burnt the first 1/3 of the cookie batch!!) LOL.

2008-11-13T09:17:00.012+11:00

If you knew you only have - at most - a few months left, how would you live your life?

To be slapped with a primary cancer is one thing, to be informed that you have disseminated mets is another....

Definition of cancer, from medline plus:

Cancer = a malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis

It sure doesn't tell you the implications of being diagnosed with it now, does it?

Having to live.... with that constant, gnawing thought of something growing inside - not just any parasite, but what was once part of you - eating at your core.... slowly, surely - until you have nothing left to give......

It's difficult. So difficult to take in.

I've met so many, who fought long, hard battles with this affliction. A few victories were won - some of them were, sadly, temporary. A portion gave up midway, but most fought to the end.

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A few of my family members had cancer - three known cases on my mom's side, three on dad's. Quite recently, another two relatives were found to have pre-cancerous lesions. Two fell - Grandpa from oesophageal Ca in the 1970s, I gather, and Grandma from disseminated pancreatic Ca.

Dad was a resident in Adelaide, when Grandpa was diagnosed with terminal cancer. There wasn't a good palliative unit in Malaysia back then, so Grandpa came over to Australia - for palliative treatment. My dad's superior granted him a year's leave from work, so he could care for his father to the last moments of his life.

So he did.

Dad told me this story years ago, on one of our roadtrips back to Teluk Intan (Perak). I'm a bit hazy on the details now, but I remember him telling me Grandpa was feeling down and cranky at the end.

Grandma was some fighter when she was diagnosed in November 2005. I was already in IMU, knowing all too well the natural progression of pancreatic Ca. Oh, how she suffered. First the bloating, then the inability to keep food and fluids down. Then came ascites. Numerous taps she had, to relieve her of pressure. The pain did not leave her (although a cocktail of meds did help later on), yet she put on a brave front right till she passed on - as always for her in face of adversity.

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

Palliative care has been quite difficult for me - not so much of its principals and management (on the contrary, what the palliative team has done is notably admirable) - but perhaps it reminded me of many things: my grandparents, people whom I have known and succumbed to their illness, of uncertainty, Death, grief & bereavement.

In spite of these, guess I can take comfort that palliative care seeks to improve a person's quality of life, without means of prolonging one's suffering.

"Thinking and talking about death need not be morbid; they may be quite the opposite. Ignorance and fear of death overshadow life, while knowing and accepting death erases this shadow."

-Lily Pincus-

2008-11-11T22:14:00.008+11:00

In our line of work, too often am I reminded of how fragile human lives can be. This is perhaps even more evident now, being four weeks into RAPP (Rehab, Aged Care, Palliative Care & Psych of the Elderly). So many debilitated beings, so many fractured minds. Many a time I find it difficult, sometimes painful even, watching someone withering away.

At times I wonder which affliction is worse - to be so physically incapacitated (despite retaining a sound mind) that one loses his/her independence, or to be wrought with progressive cognitive impairment that one begins to lose the self, with devastating consequences:

I remember a patient (Mrs. S) whom I met six weeks ago. She is in her early 80s, of English background and highly educated - she held a few university degrees and worked as a nurse before turning to law. An extremely independent woman, she had her own law firm and was actually working until she was diagnosed with breast Ca in her early 70s. Things went downhill thereafter. She had an operation, which resulted in multiple medical and surgical complications. She had to stop working. She could no longer play tennis with friends. She also could no longer care for her husband who has Alzheimer's and Mrs S. had to eventually place him in a nursing home. With her frequent hospital admissions and declining health, her social circle gradually dwindled. Apart from her husband, Mrs. S has no other relatives to turn to - her son was killed in an accident many years ago, and her only sister had recently died. When I saw her in hospital, she was admitted for bone mets, under palliative care. I recalled her being somewhat deflated, overwhelmed by everything that has happened to her and was tearful at the end.

"You should have seen me during my hey-days. I was at the top; I was once in control.... I don't know what to do now...."

I cannot think of a particular patient at the moment, to illustrate my latter statement. There are however, numerous people I've met in the past four weeks, who were once so competent, now being exploited by many (mainly where finance is concern) because of their cognitive impairment.

Sigh.

In my rather immature frame of mind, being old sure sounds hard to me. I do need to consider, however, that what I've seen in health-care settings is just a glimpse of a certain cohort. There are others out there in the community - active, fit and well - perhaps even healthier than I am..... =P

2008-10-24T23:34:00.007+11:00

The Colorectal Surgeon Song, by Bowser and Blue.

A sure sign I'm procrastinating away - scanning YouTube videos for quick entertainment and posting them up here, when I should be revising ASAP.... o_O Bleh.

Anyway, this one here is by comedian duo Bowser and Blue from Canada. Quite unlike Amateur Transplants, but I prefer the wordplay in this one. XD

Hope you like the clip....me heading off to bed first. Early start tomorrow. *winks*

2008-10-23T22:23:00.007+11:00

Just for laughs

God bless the orthopods.... =P

Ping (my older cousin) looks the part (not that all anaesthetists are as depicted above, but he fits the stereotypic bill!).

As for my friends, I figured PRINCESS could well be a dermatologist, and LIBRARIAN will make a good neurosurgeon (but minus the God's complex =P)

Do you fit into any of the medical/surgical stereotypes, by any chance? XD Let me know what you think. ^_^

More laughs below....

Familiar? =P

2008-10-22T23:17:00.004+11:00

Had a go at this personality disorder test, as posted by WeeJie in his latest blog entry. ^^

Disorder	Rating
Paranoid Personality Disorder:	Low
Schizoid Personality Disorder:	Low
Schizotypal Personality Disorder:	Low
Antisocial Personality Disorder:	Low
Borderline Personality Disorder:	Low
Histrionic Personality Disorder:	Moderate
Narcissistic Personality Disorder:	Low
Avoidant Personality Disorder:	Low
Dependent Personality Disorder:	Low
Obsessive-Compulsive Disorder:	Moderate
-- Take the Personality Disorder Test -- -- Personality Disorder Info --

Hmmmm, sort of expected the OCD bit.... but histrionic? LOL. I guess I am to some extent. =P

2008-10-21T21:57:00.005+11:00

Quick updates (^_^)":

1. When a chapter ends, another begins
.... I meant my 6-week clinical blocks. =P Finished off psychiatry rotation just last week, and it was surprisingly better than I expected. haha. Guess that's due to my initial "coloured perceptions", after receiving lots of negative/eye-raising/horrying input from peers and family members who did psych before. =P What's most fulfilling for me? - perhaps the fact that the psych teams try their hardest not to sideline medics. Special thanks to the Orygen Youth Mental Health teams (ie: Conrad N., John K., Cathy G., Rick F., Jaco E., Andy T., Jo M., Shalini A., Sam W., Narelle and visiting reg Alberto S.), the Albert Road Clinic (notably Prof. Tiller, Brent R. and reg Michael), the RMH psych unit (Kieran P., Debra C., Liet S. and David K.), and not forgetting the various people I've met at Melbourne Clinic and Sunshine Hospital! It has certainly been a pleasure working with you all!! ^^

2. RAPP, here we come!
To the uninitiated, RAPP = Rehabilitation, Aged Care, Palliative Care and Psychiatry of the Old Age....and this, my friends, is what I'll be doing for the next 6 weeks. heh. Sounds like a heck lot (and meant to be a busy block theoretically) but it's apparently a breezy rotation. =P Just two days into RAPP, and concurrently marvelling at my now rudimentary grasp of med/surgical topics.
Do you still think it's gonna be a "cruisy" block, yuen? =P

3. EOS-10.
Another 6 weeks to go, and gotta cover Emergency Med, ?Rural Health (how to study in the first place???), Psychiatry and RAPP. Not much time left, but still feeling rather sluggish....revision-wise. Heh. Better draw up a checklist of some sort. Pronto.

4. Good news - laryngitis be gone....
I'M GETTING BETTER!!! WHOPEE!!! XD

5. ....and now the "bad" news
Recent bad eating habits, reduced motivation and (even more recent) medications have resulted in me gaining 1-2kg, limp upper arms and an unflattering jellybelly. $^*#%!!!!!
[Note to self: monitor food intake, and recommence sit-ups, push-ups and tricep workouts ASAP ><"]

6. Net overtime
Swt. Just had a look at my timepiece, and behold...it's 11pm already!! Omg omg omg, been spending hours on the Net and haven't done anything proper yet!!! D*mn, I'm signing off first.... later!!!!

2008-10-16T18:12:00.012+11:00

That's it. I'm just gonna explode right here (since I can't whine anywhere else for obvious reasons)....

This stupid "cold" is getting on my nerves. Been trying every medication I could lay my hands on at home, and yet I can't shake it off. I'm still hacking away, sometimes to the point where I inadvertently stimulate my gag reflex (hence the retching and the occasional toilet-rush). I still suffer from lightheadedness and headaches, but they are thankfully getting better. My throat still burns, perhaps not as severe as the day before....but who would have thought that it would spread to my larynx? My older cousin wasn't inflicted with this when he had it!

Curse this laryngitis. I can't voice my opinions properly, my intonation's way off the mark, Matt thinks I sound cartoonish with my feeble squeaks.... have you seen Disney's The Emperor's New Groove? Right now I sound a bit like that evil Grand Vizier after she was transformed into a kitten. Hmmm on second thoughts, maybe not. Mine's more muffled. Dad says I better not talk for the next 2 days or so....but how can I stay still? I can't!!

Dammit....

I WANT MY VOICE BACK!!!! I FEEL INCAPACITATED WITHOUT IT. I WANT TO HAVE A DECENT NIGHT'S SLEEP NOT DISRUPTED BY COUGHING "SPREES" EVERY 20-30 MINUTES. I HATE THE FACT THAT I LOOK AND FEEL SO GOD DAMN TIRED EVERY MORNING FOR THE PAST 3 DAYS. I CAN'T FOCUS PROPERLY IN CLASS. I CONSUMED ABOUT 6-8 LOZENGES IN THE MORNINGS TO STIFFLE MY COUGHS, AND ANOTHER 3-4 IN THE AFTERNOONS, WHENEVER THERE IS A TUTE/CASE PRESENTATION. I WANT TO WALK ABOUT AND ENJOY SPRING OUTDOORS - IT'S SO BEAUTIFUL OUT THERE! I'M GETTING CRANKIER JUST THINKING OF THE THINGS I'M MISSING OUT ON AND I HATE THIS NEGATIVE VIBE I'M GENERATING!!!

I just want to get well soon....

[NOTE TO SELF: If I could channel my anger into something more useful, like revising Emergency Med and Psych, for instance. Heck, we've got 6 weeks to go before our exams... o_O]

2008-10-12T20:59:00.003+11:00

Ah, the Spring Early Music Festival (SEMF) - a 13-day event where university students and professors come together to present concerts, pre-concert talks (so you'll have an idea what the recital is all about!! lol) and masterclasses. XD

Didn't realize about this music fest until last Wednesday, so I've missed the first half!!! *sniff* There's still more to come, nevertheless.... so all's not lost. hehe.

What's in for this week:

Masterclass — Amy Power
14 October (Tuesday) 6:00pm Early Music Studio, University of Melbourne - 27 Royal Pde Parkville An open invitation to see into the mind of a leading young recorder player through pedagogical interaction with emerging local performers. Free entry

Stringanza
17 October (Friday) 8pm. Lorenzo Colitto & Lisa Ferguson violins, Peter Bucknell, viola join with the Melbourne Collegium. Trinity College Chapel, University of Melbourne - Royal Pde, Parkville Immerse yourself in the sumptuous sounds of Baroque strings when international guests Lorenzo Colitto & Lisa Ferguson violins and Peter Bucknell, viola join forces with Melbourne Collegium to present an exciting program of Baroque favorites and rare masterpieces: Zavateri; Bergonzi; Muffat Armonico Tributo; Vivaldi Estro Armonico; Telemann Viola Concerto; Handel; Geminiani La follia.
$40/$20 seniors/students/conc

Récréation de Musique
18 October (Saturday) 8pm & 19 October (Sunday) 2pm
University of Melbourne opera project: Soloists, Early Voices & Baroque Ensemble (dir. Greg Dikmans) Brunswick Town Hall - 233 Sydney Road, Brunswick Devised and directed by French Baroque specialist Greg Dikmans, this concert presents a musical entertainment on the grand scale. The highlight of the program is Marc-Antoine Charpentier’s Actéon, a miniature tragédie en musique that tells the story of the hunter Actéon who, after discovering the goddess Diana bathing with her attendants, is torn apart by his own hounds after being transformed into a stag by the angry goddess. This rarely-heard masterpiece is complemented by instrumental music and choruses from the opera Armide by Jean-Baptiste Lully, including the famous Passacaille from Act V, and Airs de cour by Michel Lambert.
$30/$15 seniors/students/conc

For more information: http://www.music.unimelb.edu.au/semf.html

To get your tickets: http://www.easytix.com.au

My sis and I will most likely attend the Stringanza ensemble. Would anyone care to join us? =)

2008-10-11T20:59:00.004+11:00

Sigh. Just when the weather is getting warm and glorious....

I'm now down with some cold, courtesy of my older cousin who almost coughed his lungs out two weeks ago from the viral infection. Pretty virulent, this one - apart from my sister, he has successfully spread it to the rest of our clan, with me being the latest casualty. ><"

Pretty drugged up with medications at the moment, so if you ever wonder whether I'm living in a kingdom far, far away..... let me assure you that I am for the time being, so apologies for my rather "dream-like" state!!! =p

On a side-note, Panadol Cold & Flu Max in Hot Lemon just tastes....vile. ><"

2008-10-05T22:46:00.006+11:00

Chrno Crusade - one of the better animes I've watched so far. Such a beautiful story.... but boy, did I cry my eyeballs out when I finished the last episode!!!! *sigh* My eyes are SO gonna be swollen tomorrow..... ><"

Anyway, would like to share with you this soundtrack from Chrno Crusade. A fitting piece for the ending, don't you think? Hope you'll enjoy this song as much as I do.

[WARNING: This clip contains segments from Chrno's last episode, so if you haven't watched this anime yet....and would like to see it one day, DON'T VIEW THIS MUSIC CLIP!!! =P]

Sayonara Solitaire, by Selena Crone.

2008-10-02T22:40:00.010+10:00

To watch music clip, click on link below:

UNWELL, by Matchbox Twenty

[Update: I like this clip a lot too....it shows how much of his distorted world actually comes from his surroundings - his pet dog, the toy planes and cars he plays with, the little green bear. I even found the T-shirt he wore rather cute. The statement "Love Me" inscribed may sound simple, but it's quite poignant, imploring people to love him regardless and not judge him because of his current condition.]

All day
Staring at the ceiling
Making friends with shadows on my wall
All night
Hearing voices telling me
That I should get some sleep
Because tomorrow might be good for something
Hold on I'm feeling like I'm headed for a
Breakdown
I don't know why

I'm not crazy, I'm just a little unwell
I know, right now you can't tell
But stay awhile and maybe then you'll see
A different side of me

I'm not crazy, I'm just a little impaired
I know, right now you don't care
But soon enough you're gonna think of me
And how I used to be

Me
Talking to myself in public
Dodging glances on the train
I know
I know they've all been talking 'bout me
I can hear them whisper
And it makes me think there must be something wrong
With me
Out of all the hours thinking
Somehow I've lost my mind

I'm not crazy, I'm just a little unwell
I know, right now you can't tell
But stay awhile and maybe then you'll see
A different side of me

I'm not crazy, I'm just a little impaired
I know right now you don't care
But soon enough you're gonna think of me
And how I used to be

I been talking in my sleep
Pretty soon they'll come to get me
Yeah, they're taking me away

I'm not crazy, I'm just a little unwell
I know, right now you can't tell
But stay awhile and maybe then you'll see
A different side of me

I'm not crazy I'm just a little impaired
I know, right now you don't care
But soon enough you're gonna think of me
And how I used to be

Hey, how I used to be
How I used to be, yeah
Well I'm just a little unwell

How I used to be
How I used to be

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This became one of my all-time favourites since its release in 2002, and it still is. =)

I loved it initially because of its tune and the banjo accompaniments. Unusually, I never really paid heed to the lyrics until recently.... when I did my six-week psychiatry rotation. heh. Now I love this piece even more, because it sums up what it may be like having a mental illness - or more specifically, delusions of persecution/psychosis/paranoid schizophrenia with possible mood disorders.

"All night
Hearing voices telling me
That I should get some sleep
Because tomorrow might be good for something....."

It struck me how the voices he hears are actually giving him hope to live another day. And it saddens me because he knew (deep down inside) they're not real, that he's getting unwell.

I shudder to think how it feels like when truth hits you hard on the face - to realize that you're losing grasp of reality....

2008-09-29T21:33:00.019+10:00

MANIFEST 2008@ The University of Melbourne.

Tis' that time of the year again. ^^

The name MANIFEST (which stands for Melbourne Anime Festival) speaks for itself. =P In short, it's a yearly convention held at Melbourne Uni over the last eight years (I think).

(For more information regarding MANIFEST, click HERE)

This was the first time I've ever attended an anime convention. With that in mind, and without realizing MANIFEST has such a strong foothold in Melbourne, I (unfortunately) underestimated the turnout last Saturday. My lack of insight thus resulted in an excruciating 2 1/2 hour wait under the hot afternoon sun. Just to collect my Saturday entry pass which I've booked online weeks before. Geez.

"Le pass". To think I waited in line for a 5cm x 8cm plastic card. I like the little samurai though.

Of course my "lateness" have led me to miss a number of key events I wanted to attend - most notably the Cosplay competitions in the afternoon. Some of the anime merchandise I wanted to buy even ran out of stock by the time I got there. (@&%@#!!!).

Oh well. At least I managed to procure a Kon plushie-cum-backpack, with a zipped pouch at his back. To the uninitiated, this is a character from Bleach. Haha. Reminds me of an episode when they fashioned Kon into a backpack. Hilarious! XD

Moral of the story: Collect your passes one day BEFORE you turn up....

Apart from that, the convention was actually pretty good. I was especially surprised by the sheer effort of many who Cosplayed for the event. THEY REALLY LOOKED THE PART. XD

Didn't take many pictures this time around, mainly because I was too hot (from the weather, in case you're wondering =P) and pissed by the "entry glitches".

Some of the photos my sis (Min) took on Sat:

Min with the "One Piece" crew. =)

Min with Roxes (Kingdom Hearts 2) and Tidus (Final Fantasy ~~VII~~ X)

Zelda

(Edited) ~~A character~~ Scorpion from the game Mortal Kombat taking a shine at a rather gargantuan Moogle. =P

And a few photos taken by a professional at MANIFEST ^^ (to view his picture gallery click HERE):

Seth from Trinity Blood.

~~Erm, don't know where did they come from.... although the character in red looks familiar. =P Help, anyone?~~ (edited: Freya Crescent and Kuja from Final Fantasy IX)

Don't know this one either. lol. But the costume looks good on her, don't you think? =)

2008-09-26T20:52:00.006+10:00

Hello peeps!!

Third week into psychiatry, and I think I'm getting used to it. haha.

Anyhow, just yesterday we had a range of psych topic sessions, and a consultant added some really hilarious psych-related jokes into his presentations. So I figured, "why not find them online and share them here?"

The first two were included in my consultant's powerpoint. The rest however were found incidentally on the net, which I found amusing and therefore worth sharing. Enjoy!

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Welcome to the Psychiatric Hotline.

If you are obsessive-compulsive, please press 1 repeatedly.

If you are co-dependent, please ask someone to press 2.

If you have multiple personalities, please press 3, 4, 5, and 6.

If you are paranoid-delusional, we know who you are and what you want. Just stay on the line so we can trace the call.

If you are schizophrenic, listen carefully and a little voice will tell you which number to press.

If you are depressed, it doesn't matter which number you press. No one will answer.

If you are delusional and occasionally hallucinate, please be aware that the thing you are holding on the side of your head is alive and about to bite off your ear.

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Christmas Carols for the Mentally Disturbed:

1. Do You Hear What I Hear? (Schizophrenia)

2. We Three Kings Disorientated are (Multiple personality disorder)

3. I Think I'll be Home for Christmas (Dementia)

4. Hark the Herald Angels Sing about Me (Narcissistic personality disorder)

5. Deck the House and Lawn and Streets and Stores and Office and Town and Cars and Buses and Trucks and Trees and...... (Mania)

6. Santa Claus is Coming to Town to get Me (Paranoid)

7. Thoughts of Roasting in an Open Fire (Borderline personality disorder)

8. You better Watch Out, I'm Gonna Cry, I'm Gonna Pout, Maybe I'll tell you Why (Personality disorder)

9. Silent Night, Holy....ooh, look at that froggy - can I have chocolate? Why is France so far away? (Attention deficit disorder)

10. Jingle bells, jingle bells, jingle bells, jingle bells, jingle bells, jingle bells, jingle bells, jingle bells, jingle bells, jingle bells. (Obsessive compulsive disorder)

(Note: The joke above was first published in Marooned, a magazine produced by the Cromwell House of mental health facility in 2007. It was however deemed distasteful by a number of people, and they thus demanded the editors to remove the article. Personally I do not think it has any malicious intent whatsoever. Besides, the editorial board was made up of psychiatric patients and staff from the mental health facility.... so my point is, if they (ie: the patients) found the joke funny in the first place and decided to publish it in their mag, why stir things up? For more details and comments, click here)

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Neurotics build castles in the sky.
Psychotics live in them.
And psychiatrists collect the rent.

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A doctor at a mental asylum decided to take his patients to a baseball game. For weeks in advance, he coached his patients to respond to his commands. When the day of the game arrived, everything went quite well.

As the National Anthem started, the doctor yelled, "Up Nuts," and the patients complied by standing up. After the anthem, he yelled, "Down Nuts," and they all sat back down in their seats. After a home run was hit, the doctor yelled, "Cheer Nuts". They all broke out into applause and cheered. When the umpire made a particularly bad call against the star of the home team, the Doctor yelled, "Booooo Nuts," and they all started booing and cat calling.

Comfortable with their response, the doctor decided to go get a beer and a hot dog, leaving his assistant in charge. When he returned, there was a riot in progress. Finding his tizzied assistant, the doctor asked, "What in the world happened?" The assistant replied, "Well everything was going just fine until this guy walked by and yelled, "PEANUTS!"

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

A psychologist is doing Rorschach testing on a patient. With each inkblot he asks the patient what he sees.

The replies follow this general theme: "Two people making love". "Two dogs mating". "Two women kissing." "A man masturbating." And so on...

Finally he blurts out, "Oh--That's disgusting! I can't even talk about that!"

The psychologist says, "It seems to me that you might be a little preoccupied with sex."

The patient replies, "What do you mean? They're your dirty pictures!"

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

In a psychiatrist's waiting room two patients are having a conversation. One says to the other, "Why are you here?"

The second answers, "I'm Napoleon, so the doctor told me to come here."

The first is curious and asks, "How do you know that you're Napoleon?"

The second responds, "God told me I was."

At this point, a patient on the other side of the room shouts, "NO I DIDN'T!"

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

After she woke up, a woman told her husband, "I just dreamed that you gave me a pearl necklace for our anniversary. What do you think it means?"

"You'll know tonight." he said.

That evening, the man came home with a small package and gave it to his wife. Delighted, she opened it to find a book titled "The Meaning of Dreams."

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

A schizophrenic patient comes in to the psychiatrist's office with another schizophrenic friend. "My friend is psychotic lately, he thinks he is Jesus"

After a mental exam the psychiatrist happily concludes: "You are right, I congratulate you on your insight."

"I knew it," the patient replies. "He is not My Son!"

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

Two doctors, a psychiatrist and a proctologist, opened an office in a small town and put up a sign reading: "Dr. Smith and Dr. Jones: Hysterias and Posteriors."

The town council was not happy with the sign, so the doctors changed it to read, "Schizoids and Hemorrhoids."

This was not acceptable either, so in an effort to satisfy the council, they changed the sign to "Catatonics and High Colonics." No go.

Next, they tried "Manic Depressives and Anal Retentives." Thumbs down again.

Then came "Minds and Behinds." Still no good.

Another attempt resulted in "Lost Souls and Butt Holes." Unacceptable again!

So they tried "Analysis and Anal Cysts." Not a chance.

"Nuts and Butts?" No way.

"Freaks and Cheeks?" Still no go.

"Loons and Moons?" Forget it.

Almost at their wit's end, the doctors finally came up with: "Dr. Smith and Dr. Jones, Odds and Ends."

Everyone loved it.

2008-09-23T17:39:00.003+10:00

86 Created by OnePlusYou - Online Dating Service

Not too bad, since I can't type as fast as some of my peers. =P

So how many can you name in five minutes? Have a go and let me know!! XD

2008-09-13T22:58:00.009+10:00

Some people can be terribly sick when they're drunk.

Take the young man 'cruising' on a red party tour-bus in Central Business District (CBD) with his friends, for example.

With a half-filled bottle in his hand, he was disinhibited enough to expose his balls, and plastered himself against the bus exit for all Melburnians to see his erm...."little friend".

He seemed to be enjoying himself nevertheless, taunting at us pedestrians while the bus drove by. Or perhaps he's just "out of it". His drinking pals were either not bothered with his action, or were simply too drunk to take notice anyway.

Hmmm. Quite an 'interesting' (if not disturbing) sight, I have to say.

I wonder if he will remember any of this the next morning. And I sure hope he'll get a really NASTY hangover when he wakes up tomorrow.....

A typical sight in Melbourne nightlife? I don't know about the "flasher" bit, but given that many tend to overindulge in alcohol during the weekends.... there will be a rowdy crowd or two on the streets.

2008-09-10T22:17:00.005+10:00

So it became a norm, with friends (both old and new) enquiring whether I am currently in a relationship, or if I have ever been in one. Not always, but every now and again.

So I tell them the same thing every single time: That I am not seeing anyone. That I am not interested at the moment. That I love the idea of singlehood.

What I didn't tell them however, is this: I fear many things that may potentially come with relationships. Rejection, abandonment, of not being in control....just to list a few.

In retrospect, perhaps this is why I've pushed many away. From the moment I sense something different - that spark of interest, an onslaught of advances.... I bolt for the nearest door, despite liking them too.

As you may guess, my actions have obviously baffled many, and hurt a few.

*head hung low*

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I know, I'm a complex idiot when it comes to matters of the heart.

How will I go about undoing this so-called "mess"? Good question, because I've yet to figure it out. But since it isn't exactly a "life-or-death" situation (although some might beg to differ), I'll leave it to another time. There certainly are more pressing matters at hand than this....right?

2008-08-31T09:38:00.002+10:00

Too lazy to blog properly right now, but since I've found two poems which (conveniently) echo my current frame of mind.... I'll just paste them here!! =P

A Student's Frustration, by JC Sanders.

Meaningless courses, with trials and frustration fraught -
From them, worthwhile intellectual fruits are reaped not.
Homework assignments, meant to be enjoyed naught,
How I wish the material was a little more capably taught.

In this class there is found little of true value or merit,
Yet a requirement the department did firmly declare it.
The exam was too hard, all of the students despair it,
But if I want my degree I'll just have to grin and bear it.

Embracing the Darkness and the Day, by Tori Zigler

I let the darkness smother me
What must be, after all, must be
And as I embraced the eternal night
I said, “goodbye,” to my friend – the light
It felt like this was to be the end
Never again would I see my friend
And so I fell in to a dark despair
How could I smile if my friend wasn’t there?
How could things ever be okay?
When I would never see the light of day!

Tears flowed from my eyes like rain
(Tears of frustration, fear and pain)
What was the point of going on?
When all that once was right was wrong!
If only I could find a place
Where I didn’t have to show my face
Where I could be alone to cry
(Or even better… Just to die!)
I wished for something to release me
From the world which I could not see
But no place to hide or release came
And the days kept passing just the same

Until the day when – by a stroke of luck
An idea was planted in my mind… and stuck!
Maybe, I thought, things aren’t so bad
If only I could stop feeling so sad
Surely there must be some way
To embrace both the darkness and the day
So I searched high and low
Until ideas began to flow
And some friends from someplace very far
(Friends who don’t know who they are)
Through their words made me see
That the only problem I had was me!
And that – though things for me are tough
I’d see (if I stopped sulking for long enough)
That not only will things work out in time
But that plenty of people have problems worse than mine!

2008-08-22T22:25:00.007+10:00

This little episode occured on my way back to Melbourne. Just over 4 hours ago.

There I was on the 5pm train in Seymour. It was one of those peak hours where carriages were brimming with passengers. So I sat next to a woman in her 40s. Very pleasant person, actually. We had a small chat. Turned out she was from Shepparton, and she was on her way to Melbourne. To visit relatives, she said.

She asked me where I came from. What am I currently doing here in Melbourne. And what was I reading at that time (was actually holding "The BookThief" by Markus Zusak).

I told her bits and pieces. She smiled amiably, and she later left me to my reading.

All was quite unremarkable until it was time for her to go.

She stood up, collected her bags, and gestured that she was about to alight from the train.

She leaned forward, gave me a hug and a light kiss on the cheek, then looked at me straight in the eye and said:

"Be careful. Do not always trust the people around you."

The woman walked towards the exit, and just before she left... she turned back to me - with that all-knowing look, a nod, an enigmatic smile and a slight wave of her hand.

For the next 20 minutes of my train-ride home, I was restless. Puzzled. Unnerved. Why would someone I barely know hug and kiss me on the cheek, out of the blue? More importantly, what was that warning for? What does she mean?

I still do not understand.

When erring can be fatal

2008-08-15T18:56:00.007+10:00

An elderly man (let him be Mr. N) collapsed upon arriving at the ED reception last evening, to the shock and horror of his wife and daughter.

Pulseless.

He was rushed into Trauma room 1, with a throng of people from the trauma/arrest team. CPR was commenced immediately while he got hooked onto the cardiac monitor, was intubated and had IV access established.

Ventricular fibrillation (VF). Shockable.

The team "defib-ed" him at 150.

CPR recommenced.

Femoral pulse detected. CPR stopped.

Cardiac monitor showed ventricular tachycardia (VT). Patient regained consciousness - was confused and very frightened initially. Endotracheal tube removed, some blood in the mouth (post-intubation) suctioned, amiodarone given shortly.

Mr. N was promptly transferred to a resuscitation cubicle for close-monitoring. Further management then planned.

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

All the above happened within 7-10 minutes. I could not describe exactly how I felt as I watched the event unfold. It was fast. Dramatic. And downright scary.

Apart from a sore chest, the elderly gentleman felt alright when I had a little chat with him and his family. As expected, he could not recall much of the "funny turn" he just had.

His family members, naturally still in shock, were relieved nevertheless that he survived thus far.

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Chungy was the teamleader. He later told me how Mr. N has been complaining of chest pains over the past two days. He sought help from his local GP, but instead of calling the ambulance and sending him straight off to RMH, the aforementioned GP told Mr. N to self-present at ED....

Big mistake.

Mr. N was lucky. He could have collapsed anywhere between his GP's office and ED, and not survive the attack. All because of this one GP who did not foresee the potential implications of Mr. N's chest pains (which unfortunately happened, but thankfully at ED).

Chungy said his GP could be sued for negligence.

Couldn't agree more, because I would sue my GP, should this happen to me.

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

Fellow medics - don't make the same mistake.

2008-08-14T21:35:00.005+10:00

Sigh. One more shift left. =(

Despite a few glitches, my three-week Emergency Medicine rotation at RMH has been fantastic on the whole, and for many good reasons too:

Reason 1:
I saw a fair number of patients, from all walks of life, with various presentations. While most of them are very cooperative, there were a fair few who were either:

a) drunk/out cold (no thanks to alcohol intoxication),

b) confused for various reasons (and thus can be combative), or

c) very emotional/anxious/aggressive/violent, again for various reasons.

Within my three-week stint, I've seen burly security guards holding down combative people, police officers keeping certain patients shackled to bed-rails. It was quite a sight to behold: hand-cuffed patients writhing in their beds, wailing and screaming, hurling expletives at us all, while the ED physicians and nurses tried to sedate them. I've seen workplace accidents and so many MVAs, some more gruesome than others. I've also seen intentional injuries - gunshot and stab wounds, potential drug overdose, just to name a few.

Reason 2:
I've seen how a trauma team "ticks". They never cease to amaze me - how they work so efficiently, how everything falls so nicely into place. =)

Reason 3:
Chungy!! XD

Chung is undoubtedly our favourite ED consultant. While many would rather leave us to our devices, Chungy tends to keep us medics busy. And in a good way too. The fact that he gives constructive feedback and his "easy-going" persona also makes things better. Learning new things and then applying them on the spot have never been this fun.

Pity he is not on duty everyday.... =P

Reason 4:
Procedural skills.

Got to practise them all!! Well, almost all of them. =P At the very least, I'm now confident with IV cannulations, backslabs and, to a certain degree, urinary catheterizations and suturing.

Reason 5:
Familiar faces.

Well what do you know - just when I thought I'll hardly (if never) see them again, there they all are.... seeing patients at ED: Alistair Miller, Andrew Mcleod and Andy Oppy, Tony Young, Wil Wilson, Jonathan Chan, Andris Elim, Shiva Badiee, Cheryl Choong, Glenn Boyce, and not forgetting the Pianta brothers (I didn't know they were so closely related!!! lol).

Can't believe I'm saying this, but: YOU HAVE NO IDEA HOW MUCH I MISS YOU GUYS!!!! Thanks for all the things you've taught me throughout Sem 8-9! Good to see you all once more!

Reason 6:
Group K.

Don't think I'll enjoy my rotation as much were it not for them. XD

2008-08-12T21:45:00.003+10:00

Don't you just love it when people still remember who you are, even though you haven't seen them for a while?

It may be just a small gesture - a nod, a pat on the shoulder, a smile. But it does go a long way for me, more so when the day seems dull and dreary.

It makes me happy, just knowing that I still belong....somewhere within the system. =)

2008-08-09T16:27:00.006+10:00

My mantra of the week:

The night is darkest before dawn.

Recent setbacks have kept me thinking otherwise....

But I SHALL PREVAIL, NO MATTER WHAT YOU THROW AT MY WAY, SO THERE!!!!! =P

2008-08-06T17:31:00.004+10:00

Getting reprimanded for something you didn't do down at ED really sucks.

As for the person who actually did it - he/she didn't admit his/her mistake.

No apology given either.

@*$#&@%*!!!!!

2008-08-04T20:57:00.005+10:00

It's a different feel altogether in clinical settings, with real patients and REAL problems to fix.

I must admit, learning and practising on dummies (and unwitting medics) do help - lay down the basics first, so to speak. But having to apply whatever you've been doing all along in clinical skill centres in ED? It scared the sh*t out of me initially. I shudder at the mere thought of screwing things up: from "botching" veins during IV cannulations (and having to "jab" over and over again) to forgetting my suturing techniques when I come face-to-face with a laceration that needed, well, stitching. Whatever would people think of me, should I leave a trail of mess and (God forbid) calamity?

With the exception of a few, I guess we all are afraid of messing up, some way or another.

Just one week into my ED rotation, I've cannulated so many patients (and "blown" even more veins in the process) that I think I'm getting immune to the whole thing already. So screw what people may think! =P Not that I'm turning into some cold-hearted prick, mind you. Lol. Rather, I now view my time in ED as an opportunity to practise (and hopefully improve on) my procedural skills.

Of course, the same cannot be said still for basic suturing (only did it once last Saturday, and boy did my hands shake badly!!!), but I suppose I'll improve if I keep at it. =P

What I like about applying my somewhat rudimentary skills into practice is the fact I start questioning things that I normally do not think of in "theoretical settings". Like how to keep my gloved hands and equipment sterile most of the time, what could I change with the way I do certain things to increase my efficacy, what works for one patient but does not for another.... so many questions, so many possibilities. Keeps me up on my toes, and hence I'm loving it. XD

The downside of ED? It's very unpredictable - one moment it can be empty, almost serene, and before you know it, you've got your hands full.... running up to clerk a patient or two, while the nurses/doctors call upon you to cannulate, take bloods, update patient records and prepare backslabs.

Truthfully? I prefer to be kept busy while I'm on duty. There's nothing worse than having NOTHING to do at all during your shift. It sure bores me to my wits. ><"

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This is something totally unrelated to the above entry, but I just received an email from a friend, who told me about a friend of hers (in Malaysia) who has Caffey's Syndrome and needs an orthopaedic consult. I haven't done my reseach yet as to what Caffey is about and what is its usual mode of treatment, but my friend here is looking for a good orthopaedic surgeon (in Malaysia) who specializes in ortho conditions seen in children. Any recommendations?

2008-07-29T17:41:00.010+10:00

Emergency rotation is seriously FULL ON!!!

Decided to drop in at 8am with Jules and Ali today, to gauge how things "tick" at ED.

First on the agenda, handovers, which were pretty quick as ED was only 20% full at that time.

Hmmmm.... one quiet morning, perhaps?

Not quite.

While Ali went to triage and Jules got himself a patient to clerk, I shadowed Martin for a period, who happens to be an ED registrar (really nice fellow, btw ^^). Got to do about two focused case-histories for him before the department became "chaotic". By that, I meant sudden influx of patients with a host of acute medical conditions imaginable. It wasn't long before every cubicle at ED was occupied.....and there were more patients waiting at triage, with paramedics and the lot. swt.

Out of the variety of conditions I saw this morning, the two most memorable ones (ie: most shocking for me) were:

1. A work-place accident, where a young male construction worker had both his lower limbs crushed by some concrete slab. Significant haemorrhage - the pillows beneath his legs were soaked, and we had to get towels to mop-up all the blood on the floor. Jules had the honour (albeit "coerced" by Tony =P) of "fashioning" the plaster backslabs. He did a good job, I have to say. XD

2. Cardiogenic shock(?) - patient was resting in a cubicle when his nurse noticed a sudden drop in BP and bradycardia. When he was whisked off to the resuscitation cubicles, what caught our attention were his facial expression (he looked stunned - mouth gaping, eyes wide-opened) and his complexion (completely white, just like those clean, white bedsheets at ED). CPR was successfully performed, after which he regained consciousness, became confused, and had some sort of a transient "seizure". I still don't know what to make of the latter. It was atypical; bizarre.

What I really liked about ED today were the procedural skills I could do. Good practice, really, considering we've been doing them on dummies all this while. =) Had a go at a diagnostic ascitic tap and urinary catheterisation, while my colleagues (ie: Jules and Jeanne) went for arterial lines, IV cannulations and plaster backslabs.

Overall, a fairly productive day, although I tend to get "very lost" in the midst of chaos. There were so many occasions where I didn't know where to stand (so I could get out of the way) or what I could do to help. =P Nevertheless, the ED staff are superbly nice - and they do make you part of their team.

More updates after I finish my homework. XD Lots of reading-up to do!!!

PS: Piece of advice while at ED - wear casually, and by that I mean T-shirts, jeans, comfortable trainers, and where possible.... scrubs attire. It can get really messy in there.

2008-07-27T00:42:00.005+10:00

It's one of those books I couldn't put down once I started reading. Despite being in publication for 20 years already, The Alchemist by Brazilian author Paulo Coelho is still a compelling read.

A gist of this 175-page novel before I go any further:

"This story is about an Andalusian shepherd boy called Santiago who travels from his homeland in Spain to the Egyptian desert in search of a treasure buried in the Pyramids. Along the way he meets a gypsy woman, a man who calls himself king, and an alchemist, all of whom point Santiago in direction of his quest. No one knows what the treasure is, or if Santiago will be able to surmount the obstacles along the way. But what starts out as a journey to find wordly goods turns into a discovery of the treasure found within."

In all honesty, it has quite a simple plot. What makes it good, however, are the pearls of wisdom interwoven within the story - of hope and faith, dreams, courage, love.... and many other things we tend to take for granted in this fast-paced world.

A book of symbolisms brimming with stories within a story, it is simple yet thought-provoking.

Cynics may think the reason behind The Alchemist's popularity is attributed to Coelho's acknowledgement of what his readers want to hear. Perhaps so, to some extent. Nevertheless, one cannot deny its appeal to many - we can identify ourselves with the protagonist at some point or another, we all have dreams, and we LOVE it when someone tells us that our dreams may one day come true.

Simplicity has never been so beautiful.

Title: The Alchemist

Author: Paulo Coelho

Price: AUD24.99

In short: Inspiring.

2008-07-16T20:34:00.004+10:00

I'm still not good enough for you, am I?

Am I?

Sigh.

"Don’t join an easy crowd. You won’t grow. Go where the expectations and the demands to perform are high...."

-Jim Rohn-

But it's been a long and windy road, and I'm tired.

So tired.

2008-07-15T17:31:00.003+10:00

I passed.

Oh happy day..... XD

Hope everyone else did ok. *fingers crossed*

2008-07-14T22:19:00.006+10:00

Who am I, exactly?

Honestly? I for one cannot tell, nor do I have the answer. Not now, and perhaps not ever.

"All the world's a stage,
And all the men and women merely players;
They have their exits and their entrances,
And one man in his time plays many parts..."

-From Shakespeare's As you like it-

We have played many roles in our lives; we still do:

The "seven ages", as penned by the Bard himself.
And within the seven ages, a multitude of "sub-roles" -

A son or daughter,
Brother or sister,
Cousin,
Husband or wife,
A parent;
Grandparents.

A carer, confidante,
Teacher, mentor,
Friend or foe,
An ally; an archrival.

So who am I to define who I really am, exactly? I've taken on so many forms; I still do.
So it's hard to tell really - what's real and what's not.

"All the world's a stage,
And all the men and women merely players..."

Perhaps all I can tell you is:
I am a player on the Stage;
I fleet....
between roles I'm bound by,
and roles I choose to be.

I had roles to play in the past.
I still have at present,
and I will have more in times to come.

We have our exits and entrances.

We change with circumstances; we fleet between roles.

Whether we like it or not.

Don't deny it.

We all did. We still do.

We all will.

[Note: I admit, one's gotta admire Shakespeare's insight.... despite being dead for over 400 years.]

2008-07-12T22:17:00.006+10:00

Nothing gives me more joy than simple pleasures of life....

Take baking, for one. =)

Decided one day that I should start again, given we still have two weeks off. Surfed the net, found this recipe, and *voila*:

Sweet success. Rich dark chocolate pudding with strawberries and double-cream. ^.^

2008-07-10T14:09:00.004+10:00

"Words mean more than what is set down on paper. It takes the human voice to infuse them with deeper meaning...."

-Maya Angelou-

I could not agree more. =\

2008-07-06T22:08:00.008+10:00

My three top desserts of the week:

3.

Black Sesame Ice-cream, from Tomodachi, Melbourne Central. Was recommended by a cheery waiter, after I found that my initial order (Daifuku) was not available. Creamy, with a right hint of sesame. Simply divine with its accompaniment of sweetened red beans.

2. Strawberry Tart, from The French Quarters Patisserie, Queensberry Street (North Melbourne). A perfect afternoon treat, with its "crumbly" shell, fresh vanilla-bean custard, luscious red fruits and icing sugar.

1. Chocolate Mousse, from Koko Black. Beautifully swirled and topped with caramelised nuts, it is silky, rich, decadent. Enough said. XD

Now, if only I can't grow fat no matter how much I "pigged-out".....

2008-07-06T21:35:00.004+10:00

Games Exhibition: The Aftermath

Verdict:

It evoked fond memories....of the days when I used to hog the Nintendo set at home, eyes constantly glued to the screen (much to my father's angst!), of times when I frequent game arcades with siblings and cousins, challenging them to a shooting game or two. =P

Nintendo....good gawd, now I feel REALLY OLD!!!

A fun ride overall, provided you can keep up with the undeniably huge crowd (which meant more waiting and less play time)....

[SIDENOTE: PO YIN AH....WHY DID YOU HAVE TO GO BACK SO SOON??!!! WE COULD HAVE PLAYED DANCE REVOLUTION AND MADE COMPLETE FOOLS OF OURSELVES TOGETHER!! =P]

2008-07-02T21:41:00.005+10:00

Game On: The History of Video Games Exhibition @ ACMI

Specifically for gamers, or for anyone who'd like to re-live their childhood days. XD

Until Sunday 13 July 2008
Australian Centre for the Moving Image (ACMI), Federation Square
Open daily 10am - 6pm, Late night Thursdays until 9pm
Full $15; Concession $10

A gist of what's in store:

"Get ready for Melbourne's must-see exhibition of 2008 - the action-packed celebration of games culture that has thrilled over one million players of all ages around the world. Game On tracks the development of videogames from the first computer game to arcade-era hits and the very latest from today's billion dollar industry...."

"Original illustrations by Mario creator Shigeru Miyamoto and concept sketches behind classics like Tomb Raider and Grand Theft Auto provide unique insight into the creative process of game development. Rarely-seen consoles, controllers, arcade machines, packaging and collectables are brought together in a showcase of game history like no other....."

[excerpts taken from http://www.acmi.net.au/game_on.aspx]

Anyone interested? =)

2008-07-02T12:25:00.004+10:00

IT'S OVER! IT'S FINALLY OVER!!

WOHOO!!!!!

Amazing how the exams fly by really quick once they begin. ^^

Long-case was....erm, to be honest, it was a relatively straight-forward cardio case, chief-complaint being acute dyspnoea at rest. The patient was really nice and cooperative too. My main problems were:

1. Time-constraints (don't all of us have them =P)

2. A terrible mental-block at one point, which caused me to answer one of the examiner's questions REALLY poorly *kicks self in the rear-end for being such a dumb@$$*

3. Deciphering signs which pointed somewhat to aortic regurgitation (PLEASE LET THIS BE CORRECT!!!), and

4. MARFAN's SYNDROME!!!

Yes, you heard that right....I've got a patient with Marfan's, and I DON'T REMEMBER MUCH OF THAT CONNECTIVE TISSUE DISORDER!!!!

GAH!!!!!!

The examiners were really nice though. Perhaps out of sympathy, considering I looked horribly nervous, and stumbled every now and then during presentation?

Pffft. Oh well. It's over now. And I'm glad it's done with.

I'll worry about this more when "result-time" approaches, in mid-July. =\

2008-06-22T17:20:00.003+10:00

My uncle's home seems more quiet than ever before, now that my sister has left for KL.

It's only 4 hours since, but I miss her already!!! =(

Revision-wise, things are going REALLY slow in the neck of my woods, no matter how hard I try. My mind wanders too easily these days. *sniff* Last resort: practise lots of MCQs and picture tests. I don't know if it's the right thing to do at the moment, but that should keep my mind preoccupied a bit. ><"

More updates later.

2008-06-17T19:30:00.005+10:00

I DON'T REMEMBER ANYTHING....

I CAN'T RECALL WHAT I'VE STUDIED IN THE PAST.

I KEPT FORGETTING MY PROCEDURAL SKILLS,

OR WHAT I'M SUPPOSED TO KNOW AND DO IN AN ADVERSE EVENT.

I DON'T KNOW HOW OR WHERE TO START, AND WORST OFF

I CAN'T HELP BUT DOUBT MYSELF IN EVERYTHING I DO AT THE MOMENT....

SOMEBODY SLAP ME!!!

*hyperventilates*

2008-06-10T23:49:00.002+10:00

Exam prep is wearing me out. Not so much of the studying bit (although the fact that I retained only 30% of what I've read so far is horrifying!)....it's more of the intense "rivalry" between a couple of students (whom I shall not name, but I can proudly tell you it's not my group!!! =p) that got me all stressed. Their drive to excel, the competitive streak - and not forgetting their "I'm-superior-than-thou" attitudes have simply driven me up the wall.

Sigh. Another two weeks to go. Can't wait for this to end. =\

2008-05-31T22:55:00.002+10:00

I was completely bowled over when I found this "Nerdy Pick-Up Lines" group on Facebook. Gawd, I wonder how they came up with these in the first place. Classic! =P

Listed below are a few of my favs:

1. You have nicer legs than an Isosceles right triangle.

2. My love for you is like diarrhea, I just can't hold it in.

3. Baby, I know my chemistry, and you've got one significant figure.

4. You're hotter than a bunsen burner set to full power!

5. Are you cos^2(x)? Because I'm sin^2(x) and together we are one.

6. If i was an endoplasmic reticulum, how would you want me: smooth or rough?

7. By visually measuring the wrinkles in the front of your pants, calculating your body mass based on your height and weight, and dividing that number by your waist size -- I conclude that you have absolutely nothing in your pocket and are, in fact, glad to see me.

8. By looking at you I can tell you’re 36-25-36, which by the way are all perfect squares.

9. You’re so cute you make my zygomaticus muscles contract. (Muscles that make you smile)

10. Want to meet up so I can excite your natural frequency?

Word of caution: Don't use them on anyone....ever. =P

2008-05-22T22:56:00.002+10:00

There are moments like this when I simply want time to stand still....or put it in a better way, COME TO A GRINDING HALT, so I could take everything in one at a time. Breathe properly, for once. =\

Sigh. So much to do, so little time.

Being in pre-exam mode is NOT FUN at all. Everything seems dreary and hectic, now that it's less than five weeks to our BIG Sem 9 examination. Good cases are getting harder to come by as well, no thanks to sudden gush of medics and registrars practising for their respective exams. At the rate things are going, I might as well start turning up on Saturdays to look for patients.... I have done it once, so I could just as well do it again!

So many people I know are falling ill, and I shall blame it on two things: chronic stress and the weather. It's freezing here!!! Man, do I hate it. Speaking of health, I think I'm getting sick myself. Throat's getting awfully sore today. Great, just great. After all the things I've been doing to keep myself healthy.... ><"

As for revision, I am seriously lacking in motivation. Somebody help me.....

[NOTE: Do forgive me for whining in this post. I simply need to rant somewhere....it can be "therapeutic" for me sometimes. =P]

2008-05-17T22:58:00.004+10:00

My Fair Lady, Opera Australia: Review

Just attended Australian's version of My Fair Lady at the Victorian Arts Centre, this afternoon.

I was a bit disappointed with the first act and a few actors. The score "Wouldn't it be Loverly?" during the first act was sung dismally in my opinion. The chorus, in particular, 'drowned' the lead actor's voice at one point. A shame, really....since she has a beautiful voice. As for the actors who did not meet my expectations, let's just say that their presence on stage was not commanding enough. Heh. Then again, given that the 1964 film "My Fair Lady" (which starred Rex Harrison and Audrey Hepburn) was executed to near perfection, they have a lot to live up to. People tend to compare between productions. Heck, even my views and expectations are "coloured" by the film! =P

[To my readers who have never watched this film before, I'M URGING YOU TO WATCH IT AT LEAST ONCE IN YOUR LIFETIME! IT'S SERIOUSLY SOMETHING YOU SHOULD NOT MISS!!!!!]

[My Fair Lady (1964): Audrey Hepburn as Eliza Doolittle, and Rex Harrison as Prof. Henry Higgins]

Apart from that, it was enjoyable overall. The costumes and backdrops were superb, choreography was good, and the actors who played Alfred Doolittle, Mrs. Pearce and Mrs. Higgins really packed a punch! XD

2008-05-10T10:32:00.004+10:00

That's it. I'm sick and tired of being so uncertain (of my abilities), to the detriment of my performance in many aspects of MY LIFE.

I believe I could have fared better, were it not for my "low-ish" self-esteem....so as of now, I'm NOT gonna let it BOG me down anymore!!! ><"

2008-05-09T21:06:00.004+10:00

It's scary, watching the days slip by - like fine sand in an hourglass - flowing, draining.

Next week, I shall begin another clinical rotation - Cardio/Resp/Gen. Med - the final block before my finals on 25th June 2008. (sigh)

All in all, my last block was quite a different experience. Although I detested the idea of cramming five secialties into a six-week rotation, it has nevertheless been a good ride. Among the five, I think I have gained most from the Orthopods and Rheumatologists, since they comprised a larger portion of my coursework. Many thanks to the numerous residents, registrars and consultants I have crossed paths with over the past six weeks. I might not have enjoyed this rotation, were it not for them all. =)

2008-05-07T18:29:00.001+10:00

Post-mortem

*wipes sweat off brow*

Well I survived, didn't I? =P

Jokes aside, it was overall a very interesting experience. At the very least, I've come to know my strengths and flaws...so that's good. Timing was within acceptable range (ie: 12 minutes), and flow was smooth. My case was admittedly simple nonetheless, a stark contrast to Tony Chen's patient, which was one "jackpot" of a case (and every medic's worst nightmare)!!!

[A big "THANK YOU!" to Tony Young (ortho reg), who advised me NOT to take on overtly complicated cases for long-case presentations!!]

The discussion and Q & A bit was a little tougher, since my mind went into what one might call a "chaotic/manic mode" at that time. Ideas came whooshing by, but expression of ideas and tackling questions are, again, not exactly my forte. heh.

The flow will definitely come....it will just take some time, a bit more practice and a hell lot more confidence!!! =P

The mini feedback session was invaluable, and it was something I really have to thank Dr. Smallwood for. XD

I have no regrets going out there. So I highly recommend every student at RMH to have a go at it. At least once, at the front with Dr Smallwood and Co. It's undeniably daunting, but hey, I learnt a few valuable things in the end....rest assured you would pick something up.

To everyone else who have helped me along the way - to Wee Jie, who helped to obtain a printout of my case results for Dr. Smallwood; to Ali, Jeanne and Jules, for the constructive feedback you've been giving me; to Belinda for the constant support; and to the rest of the medics who did not "boo" me whilst I was in the "hot-seat" - THANK YOU!!!

2008-05-06T22:48:00.002+10:00

In less than 24 hours, I'll be placed on the so-called "hot-seat" at Lovell Theatre, where I shall present a long-case for a consultant (or two) and my cohort, followed by a 10-15 minute discussion/questioning session.

I knew what I was getting myself into when I first raised my hand two weeks ago. It meant more work for me, more "patient-scouting" to do, and lots of reading. Nevertheless, it was also a chance to push boundaries, to see how far I could go before I break. To conquer fear.

I never liked speaking in public, more so in front of people who are, on the whole, far superior intellectually than me. I hate to think of the worst, but I am (unfortunately) at this very moment.

So yes, you could say that I am petrified - of failing and "public" humiliation.

I have my case ready - a neurological one. Not perfect, but hopefully presentable. Considering neurology IS my weakest link, how did I ever decide on this case is still beyond me.

On the brighter side, this is where I can see how far have I gone since I started clinicals last July/August.

Sigh.

Note to self: THINK POSITIVE YUEN, GODAMMIT!!!

More updates tomorrow, after presentation.

2008-05-02T18:18:00.004+10:00

A year older, a year wiser?

Just this morning, my clinical group asked me on how will I celebrate my birthday. Good question.

Generally, I do not celebrate mine with a bash of sorts. Unless my more "westernized" relatives and friends decide to throw a surprise party, it's usually a quiet affair. My immediate family do not celebrate birthdays in a big way. Of course we exchange birthday greetings and presents on the day itself, but it usually ends there.

Friends can't help but think that it's odd - birthdays are meant to be happy events, and it is only fitting that they are celebrated with a "bang".

I do not see eye-to-eye with my mates on the latter. Big celebrations are just not my thing, which is partly the reason why I get uncomfortable (and embarrassed) whenever people throw birthday parties for me. Call me an oddball, but that's just the way I am for now. I might get used to it in the near future, but bear with me for the time being.

So what do I usually do on my birthday, you might ask. You could say that I just carry on with my daily routine. Nothing out of the ordinary, apart from replying well-wishers' messages and reflecting on what I've done in the past year.

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

To my friends and relatives who remembered my birthday and sent well-meaning greetings and prezzies, to Group K (Belinda in particular) who had painstakingly baked a cake, brought ice-creams to RMH and sang "wholesome-ly" at the student common room, I thank you all...deeply and sincerely.

2008-05-01T17:02:00.003+10:00

This is clearly one week when things don't go according to plan.

No matter how hard I try to find time (which, unfortunately, I've been lacking of lately) so I could do something useful, there will ALWAYS be some event which comes along the way and completely mess my schedules up.

Take my unexpected visit to the Student Union dentist yesterday, for example. Just two days prior I was flossing my teeth, and before I knew it I chipped a chunk of my dental filling off! So I hastily booked an appointment....and at 11.15am (after plastics GWR), I was seated at the dental office. The refill went smoothly, apart from the fact that the LA used was a bit strong for me, so I ended up with:

1. A "partial lower motor neuron weakness" of my lower jaw and tongue (ie: I spoke funny, had a sign akin to L. hypoglossal nerve palsy and I couldn't smile properly!!),

2. A really anaesthetic L. mandible, L. lower lip and left portion of the tongue

3. Nausea

Those symptoms lasted for about 3 hours. So yes, I felt crappy.....particularly during the first half of the fracture clinic which I attended from 1.30pm (YES, I KNOW I SHOULD TAKE LEAVE IF I'M FEELING SICK BUT I DON'T WANT TO AT THAT TIME!!!).

[A good thing I didn't in the end, as I learnt a great deal at clinic with Mr. Bucknill (consultant) and Jike (ortho registrar).]

Other things that did not turn out well:

1. Did not go into OT this week. A shame, especially when there WAS a TOTAL HIP REPLACEMENT just this afternoon, which I was DYING to go but I cannot as we had PBL discussion and a radiology tute, which lasted till almost 4.30pm. The operation started at 1pm and was expected to finish at 5....so it was rather pointless for me attending after tute. sigh. I could try my luck tomorrow, provided there is a good surgical case medics can go to.

2. Long case presentations. I initially planned to clerk and examine at least 3 patients this week, so I could pick one out of three and present that case for next week's "D-day". I've managed to complete one case only so far, no thanks to many upheavals in my timetable (which meant I had to prioritise). Tomorrow's Friday already.....and from the look of my schedule, I think I could squeeze in a slot for a long-case. However, that would mean I have to skip OT (again).....

3. Catching patients (for aforementioned long-case presentation). With my now jam-packed schedule, I could only look for them either in the morning (between 8 - 8.30am, provided I don't have WRs or early tutes) or in the evening (ie: after 4.30pm). At the moment, I do not have much luck finding good medical/surgical cases.

4. Revision. Again, another problem area for me (and other medics) =P Notes pilling up high now. [Major exam's in 7 1/2 weeks, for your information. DAMMIT!!!!]

5. Keeping up with others' expectations. A tough call when one (with exceedingly small brainpower) has to juggle with five specialties, and I think I've disappointed a few people along the way.... *bows head in shame*

2008-04-27T17:28:00.005+10:00

Do I Walk Funny?

It could be just me reading too much orthopaedic material over the weekend, but....my left lower limb appears more externally rotated (by 5 degrees, perhaps?) and a tad shorter than my right. So how on earth did I start noticing this? Umm, let's just say that I've been habitually reading on my sister's bedroom floor, sitting erect with my back leaning against the bed, legs straight at the front. From time to time, I tend to look up from my books and ponder on what I've just read. So.... you could say that I noticed the "defect" during one of those "reflective moments". heh.

Would anyone care to examine my left lower limb? =P

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The additional holiday we had (ie: Anzac Day) plus weekends have been therapeutic. For one, I managed to catch up on much needed sleep, to the expense of my revision schedule! hehe. I've never felt better, nevertheless. At the very least, I won't be lurking the hospital ground this week looking like the "undead". =P

And now, back to my final PBL trigger and anaesthesiology....*groans*

2008-04-24T22:54:00.005+10:00

Had my plastering session today. IT WAS AWESOME!!! Ken Lewin, the plaster cast technician, gave us a really informative "run-down" on the types of casts as well as the principles of treatment and management before we got down to "plastering" each other's forearms.

Good fun, but the plaster mould I made for Jules didn't turn out nicely though. =P Not smooth enough, a tad short and Jules could not bring his little finger and thumb together! It didn't help too when he kept laughing at me throughout the procedure!! LOL.

The sawing, prying and cutting part was gruelling, to me at least. haha. There were just so many instances when I thought I was going to cut through Jules' arm with the electrical saw!

Can't help but wonder how it will be like plastering an actual patient's forearm. I personally think it won't be as simple, firstly because the patient might still be in considerable pain. Also, one has to take into account the type of fracture he/she has, what kind of plaster mould should one do, and whether or not the patient should keep his/her wrist and forearm in neutral position.

Would really like to attempt plastering again....but given that we are already at the end of week 4 (of the 6-week block), I guess I don't have much time left. =(

Apart from the odd pathology lecture and professional development (PD) tute, today was pretty much "full-on Ortho". Went for the morning WR with the Orthopods from 7am, had two very interesting ortho tutes with Mr. Pirpiris and Mr. Bucknill, and as I've already mentioned before, attended a plastering session. Haven't got the time to see patients up in the wards or view recommended X-rays at all....but had a quick chat with a patient (whom I clerked and examined yesterday) after patho lecture. She's doing pretty well, and if things are smooth-sailing, she'll be wheeled to theatre this Tuesday.

Speaking of surgeries, I haven't scrubbed-in since that one-day-shadowing-stint with Ms. Pitcher at Sunshine Hospital last year. Tony (ortho registrar) and Glenn (ortho resident) suggested that I should one of these days. As Tony quipped before, "How would I know that you can scrub-in properly if I don't see you do it in the first place?" Hmmm. Very true. Given the fact that I'm a klutz when it comes to anything "hands-on", I better make an effort to brush-up!

Next Wednesday or Thursday might be a good time to go into theatre. I'd like to know what cases will be on first though. I wouldn't want to attend one so I could merely scrub-in. It'll be a great opportunity to catch up on some anatomy plus surgical principles and treatment options before the operation....also, I don't want to look like an idiot in front of the surgeons. =P

Just a sideline - ever had those times when you go, "Wow, I've never thought of that before....but since I do now, I'd like to know more!" when someone questions something first?

2008-04-19T12:57:00.005+10:00

To everyone currently residing in Australia, you might have known by now who these two people are. To the uninitiated, however, let me give you a run-down on their story first:

Meet John and Jenny Deaves. He is 61, she 39. They have been a couple for 8 years running, had a son, Jackson, in 2001, who died just days after he was born with Tetralogy of Fallot (ie: a congenital heart defect), and a healthy daughter, Celeste, who is currently 9 months old. They are pretty much contended with what they have at the moment - a seemingly happy family on the outside. There is a twist to their story though - John is Jenny's BIOLOGICAL father.

I kid you not. John Deaves separated from Jenny's mother when she was just a year old. Jenny had little contact with her father over the next 30 years....right until 8 years ago, when she decided to "track him down". Both met, and two weeks down the line they began a sexual relationship. As mentioned earlier, John fathered two of Jenny's children, one of them is currently 9 months old.

Their story was made public on the 9th April, when it was aired on Channel Nine's 60 minutes.

"John and I are in this relationship as consenting adults. We are just asking for a little bit of respect and understanding..." (Jenny Deaves)

"John is my father and he's also my partner. We don't see each other as 'father and daughter'. I don't see John as my father, even though he is my biological father...." (Jenny Deaves)

"I class myself as a man who has met a woman and we got romantically involved...." (John Deaves)

"The way I look at it, it's just like if I was married to Jennifer and she was not my biological daughter and we had a child. It's exactly the same thing. The child is not deformed. It had no mental difficulties. Quite normal, healthy child...." (John Deaves)

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When I first realized what was unravelling before me (on Herald Sun - I haven't the time to watch proper TV programmes in the last few weeks), I was shell-shocked. Then came disgust, rage and pity.

I was stunned by the fact that these two people would consent to a sexual relationship, knowing very well that they are biologically related.

I felt sick to the core whenever I think of them sharing the same bed.

I was aghast that they (still) think it was okay for them to do so.

I was enraged by the fact that Celeste and Jenny's two other children (from her previous marriage) were all aired on this programme.

I was not happy with the way Channel Nine handled this story - based on their transcripts, I was under the impression that they were "normalizing" the situation.

My heart goes out to those who were hurt by these two incredibly selfish individuals - Jenny's mother, John's 2nd wife and the children he fathered from his 2nd marriage, Jenny's ex-husband and the two children she bore from this union, and especially Celeste....who will bear the brunt of this incestuous relationship in years to come.

Some links to this scandal:

Forbidden Love, from 60 minutes

Incest began 'on business trip', from Herald Sun

Deaves incest couple say: Don't blame us, from Daily Telegraph

2008-04-17T18:22:00.008+10:00

I'm DEAD TIRED.

This block's one hell of a ride - so much to do, so little time....

Why did they ever lump FIVE major specialties in six weeks is still beyond my reasoning...but don't get me wrong. I ABSOLUTELY LOVE THIS CLINICAL BLOCK (surprise, surprise!). To be exact, this is one of the better surgical rotations I've had so far. Everyone I've crossed paths with are approachable (a few in a scary, sort of way =P), extremely passionate about their work, and are really keen teachers/mentors.

If only we didn't have to rush through.....I'm always up on my toes!!

On a side-note, if any of you medics are wondering which medical specialty "suits" you, check out the medical self-assessment at www.mymedicalcareer.com.au. I've taken the test, and the following are my "top 2o" specialties I could consider in the near future:

1. Nephrology

2. Medical oncology

3. Infectious disease

4. Cardiology

5. Radiation oncology

6. Pulmonary/Critical Care Medicine

7. Neurology

8. Child neurology

9. Paediatrics

10. Physical medicine and rehabilitation

11. Family practice

12. Haematology

13. Endocrinology, diabetes and metabolism

14. Neurosurgery

15. Gastroenterology

16. Orthopaedics

17. Medical genetics

18. Urology

19. Child and adolescent psychiatry

20. Geriatrics

The results are what I've expected somewhat. As I'm more medically-oriented at the moment, it's no wonder that so few surgical speciaties are on my top 20. I'm really, REALLY surprised that nephrology and oncology topped the list though.

Oh, and if you guys are wondering which specialties are at the bottom of my list:

5. Preventive medicine

4. Anaesthesiology

3. Emergency medicine

2. Pathology.....and lastly,

1. Diagnostic radiology

To my IMU friends who knew I've taken another medical aptitude test in the past, let me tell you that unlike the former, I did not have to answer 130+ questions. It was quicker, and the questions were not repetitive.

I'll definitely retake this assessment at the end of next year, just to see how much (or little) my options change with time. =P

2008-04-11T20:48:00.003+10:00

What's in a name

Ever had your name mispronounced before?

I have on many occasions, and I must confess, the results can be both amusing and exasperating at the same time.

Granted, my Chinese name looks "confounding" to many in the first place (ie: Sze Yuen), so I can't blame them entirely.

Since my transfer to Melbourne last year, many people I know have grown accustomed to addressing me as Yuen (pronounced "Yin"). The others, however, still tend to call me:

1. Zee

2. See/Sii

3. Sue

4. Sei

5. Sei-Yoon *cringes*

6. Yoo-en/Yoo-an

7. Yune/Yoon

8. Iiiing (!!!)

Naturally, a few were so "off the mark" that I simply do not respond when they call. =P

2008-04-07T14:31:00.004+10:00

I admit, surgical rotations have never been my forte. This is partially due to my general "disinterest" in anything surgically-related. Henceforth, the clinical block I'm currently undertaking shall prove to be challenging for me, not only because it is surgically-oriented in many aspects (we have Orthopaedics, Perioperative Medicine and Plastics this term), but also because this rotation deals with subjects that we barely cover back in preclinicals (Dermatology, Anaesthesiology, *Rheumatology).

[*A few key topics in Rheumatology were dealt with adequately during preclinicals though. Topics covered then include OA, RA and gout!]

I am looking forward to a great rotation, nevertheless.

2008-04-04T23:24:00.007+11:00

I got "tagged" yet again....this time by our one and only - Leng Hui! =P I figured since I have some time to spare, I might as well get this done with. heh.

[Note to Leng Hui and fellow readers: What do you WANT from me anyway??? =P I mean....8 RANDOM FACTS!!! You guys know me in person already, so what more would you like to know? *grins*]

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The Rules

1. Link to your tagger and post these rules.

2. List eight (8) random facts about yourself.

3. Tag eight people at the end of this post and list their names.

4. Let them know they've been tagged by leaving them a comment on their blogs.

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Right-o. Now moving on to 8 random facts about *coughs* yours truly:

Random fact 1:

I talk in my sleep. How did I find that out in the first place? When I was younger, I used to sleep in the same room with my parents. Thereafter I shared a bedroom with my younger sister for a while. They discovered my "sleep-talking". Not sure if I still do that though. [Question to my IMU-KKB buddies: Did you guys notice anything "out of the ordinary" when I bunk in your rooms? =P]

Frankly speaking, I didn't really bother to find out what I've said during such episodes.....I finally asked my sister yesterday, and her reply - there were times when she couldn't comprehend as I was rambling nonsense; on other occasions I was "happily" rambling about friends from school!

Hmmmm.....

Random fact 2:

I've lost 14-15kg in total since I started my weight reduction regime in 2005, right after EOS-3. So far, I've managed to keep those kilos off. Am I proud of it? You bet I am, so hear me gloat. =P

It was NOT easy at the beginning though. Old habits certainly die hard, so it took me a while to adjust my behavioural lifestyle. I loved food then (I still do), I was an emotional eater, and I was pretty much a couch potato. Top that off with mental stress during my preclinicals, and my general well-being went downhill: I slept late, I ate more junk, I was chugging down mugs of coffee to keep myself awake, I became even more sedentary. The wake-up call came when I started getting breathless after climbing just three flights of stairs in IMU. That was not a good sign when you are 20 years old. My BMI was 27+ then (which was considered OBESE by SouthEast Asian standards).

Looking back, I definitely have come a long way. My BMI is currently around 22, I make sure that I eat properly (although I allow myself to indulge every now and then), I feel fit and healthy, and I've never felt happier.

Random fact 3:

I have "stage fright", which may come as a surprise to fellow Trinitrians out there as we did drama during our foundation year. Perhaps not so much when I KNOW I'm on stage with my drama team. I notice, however, that my fear escalates when the spotlight's specifically on me.

It was really debilitating when I first started clinical school - I found myself tongue-tied whenever a question was directed to me, more so when there were at least 10 pairs of eyes staring back at me. I also had trouble articulating my thoughts, and hence presenting a case/clinical findings was never smooth-sailing.

[Matt and Wee Jie, you do remember how it was like then, don't you? =P]

Do I still get those "panic attacks"? Yes, I do....although they are (thankfully) not as frequent as before. Regular interaction with people at hospitals over the last six months did improve my confidence and communication skills. I am, at the moment, more at ease with the way I present myself. I think I am calmer in the face of "adverse events", although I still get uptight whenever something unexpected (or unpleasant) occurs. My clinical group helped me along the way too.

Random fact 4:

Yes, I am single and still loving every minute of it. XD

It irks me sometimes how a few of my extended family members and friends tend to gasp in horror and go, "What?? Already 23 and STILL not attached?!!!"

They made it sound as though I've committed a cardinal sin or something.... =P

First off, I'm 23, not 32. My mother married my father when she was 29, and had me when she was 31. Therefore, I'm absolutely in no hurry to start a family. Secondly, I love my freedom too much. Sure, I do have my fair share of fantastic male friends (and I admittedly fancied one of them in the past), but the point is....I don't think I am ready to commit just yet (sorry guys!).

[Note: Anyone who would like me to change my mind could try...but be warned that I'm a full-fledged Taurean/Wood Ox (lethal combo), so I'm difficult to budge! =P]

Random fact 5:

I'm terribly shy by nature, and I get embarassed very easily [First sign to look for: REALLY RED EARS and CHEEKS!] It's quite a vicious cycle, really. When I'm embarassed, I blushed. Then when someone pointed out that my cheeks were red-hot, I blushed even more!!! ><" A few people thought that was cute though. Whatever people may say, I do not think they are good traits to have when you are in med school. heh. Looking back, I guess I have progressed a fair bit in the last six months. Perhaps it's because I am perpetually surrounded by loud and "larger-than-life" medics/docs during the week? =P

Random fact 6:

I bruise easily. No, I do not think I have bleeding disorders. I guess it's more of the fact that my veins are very superficial, so whenever I knock into something, purpuric rashes form frequently, no matter how mild the "trauma" was. There are even many occasions where I discover bruises (particularly over my legs), and I don't recall knocking myself into anything! Hmmm.

I believe there is a benign condition afflicting young women, whereby they have bruising tendencies (it's somewhere in Kumar and Clark's Clinical Medicine, I swear by it!), so.....perhaps I have that medical entity?

(Note: I'm quite a klutz too, by the way. =P)

Random fact 7:

I still have my "security blanket" (more like a mini-pillow actually) *grins sheepishly* I've had it since I was 3, I think. My maternal grandmother made it for me. =)

Random fact 8:

If Leng Hui's vice is shopping, then mine would be food. To me, food is more than just sustenance. Often I find them a delight for the senses - from the interplay of contrasting colours on the platter, the aroma of wondrous spices right down to taste and texture as one savours something for the first time. Admittedly, I liked food too much for my own good in the past (refer random fact 2), so I watch my portions whenever I eat now. =P

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Finally, my turn to tag 8 "lucky" people (!!):

1. Sidd
2. Ken
3. Johan
4. Christabel
5. Ionie
6. May Ying
7. Evie
8. Chuks! =P

Anyone else who wants to share 8 random facts about themselves are also welcome to do so!

2008-04-03T21:53:00.003+11:00

[Clockwise from top right: Jeanne, Yuen, Matt, Wee Jie, Julian, Belinda, Ali. Jom was not present when this photo was taken. Picture courtesy of Prof. Greenberg, our Professional Development (PD) tutor]

This is my clinical group at RMH. We totally rock....seriously. =P