Friday, December 03, 2010

On finishing medicine

Yes, that's right, all faithful followers of my blog (which I suspect there is none, considering I haven't been faithfully blogging...)

Sida is finally finished with medicine! Well, actually, as I'm typing this I'm still waiting for confirmation that I've passed my final exams. Due to be published by 5pm today.

On my first day, the Head of School said to us: "It will be a long, difficult year, followed by another long, difficult year, followed by two long, difficult clinical years... followed by a long difficult internship..."

If I had to summarise my 4 years in the shortest way possible, I think I would agree with what the Head said. There has been tears, there has been struggles...

I think back to the endless pages of pathology... endless warnings of "If you don't learn this or if you forget this then someone will die,"... endless lists of causes, diagnoses, investigations and management... drugs, doses, side effects, interactions... endless lists involving, it seemed, everything under the sun.

Then there was the human factor in it. I still have clear vivid images, in my mind, of various people I've encountered. The old dying man, sobbing by his bed. The placid (and flaccid) baby 4 hours before he died. The girl with schizoaffective disorder... the demons in her mind more debilitating than any physical illness. The parents of a young man in ICU after an overdose. The same young man, bleeding out of every orifice and vital signs plummeting before my eyes... then, the dead body, waiting to be 'pronounced'.

There was joys in it, too, don't get me wrong. But perhaps it's something in my character, or the character of the human condition overall... the joys are short lived, but the face of a dying baby haunts you forever. Suffice to say, it has been a long and difficult 4 years.

But now, I've come out of it... and I get the title of "Doctor". Perhaps I'm feeling a little tired and jaded, but that doesn't seem much of an incentive to me, and I'm not feeling particularly enthusiastic about using that title. I suppose it depends on who is using it and how you look at it, but there is something very humbling about that title. Doctor is someone who has seen your condition hundreds of times before, but is scared that she is starting to feel numb towards you and your condition. Doctor has been given front-row seats to human pain and suffering, and could do nothing about it. Doctor is someone whose every successful treatment is defined strictly within the bounds of protocols, guidelines, and meta-analyses of randomised controlled trials. Doctor is expected to be human in her compassion, empathy and care. And yet, she is not afforded the luxury that is given to every other human: she is not allowed to make mistakes. She is expected to "know best".

Is it any surprise that depression, divorce, and alcohol dependency is so high amongst doctors?

Anyway, I digress from the point. The point is, I'm finished, and I'm a doctor now... not really the end of the journey, but the beginning. Naturally, I would give thanks to those around me (you know who you are)... who put up with me the best way they could. And I would give thanks to my God. Only You and I know about the bitter complaints I uttered to you, during my darkest hours. Only You and I know about the times when I wanted to let go, the backsliding, the childishness, the pride, the tears. You didn't let me go. And, if the past 4 years is any indication, Lord, then I'm going to need more and more of You.

Friday, June 11, 2010

Why I can't be a paediatrician

There was a time, for a while, when I thought I was interested in paediatrics. Of course, this was before my actual term in paediatrics.

I thought paeds might be good for me, because as a radiographer I was good at working with children and always enjoyed the extra challenge. Plus, I wanted to keep my scope fairly general, I'm not really interested in specialising in something in a very small area. (I've since learnt, of course, that babies are very small, and specialising in something like neonatology essentially means specialising in an entire creature that weighs less than my lap-dog.)

My preconceived ideas of good with children was thrown out the window when I was asked to see a 2 year old child with sudden "inability to walk" - her mother suspects the child's legs are weak, but of course there is no way to get the child to tell you that. How do you do a neurological examination on a toddler? The child was in no mood to cooperate, was in no mood to allow me to test the power of her legs, and of course went into hysterics when she saw me approach with the tendon hammer to check her reflexes. My brave smile, my praises and coaxes, my flattering speech about the pretty butterflies on her dress, all fell on deaf ears. (Actually she was screaming so much I doubt she heard me.) In the end, I picked her up, watched her then run back to her mother, and then proceeded to report to the doctors that the child's lower limb power was "grossly normal" since she could run. Give me an irate adult that I can reason with, any day.

I think, though, the biggest problem with paeds is that I have a real soft spot for kids. I think they are all cute and beautiful and little balls of potential and hope and germs... and I really can't stand it when I see kids sick. I'm starting to get better about it now, but at the begining, even reading about paediatric diseases used to make me feel sad. I'd be reading a condition, like spina bifida, and I'd think... aww, poor baby, you poor thing. Then I'd have to tell myself to snap out of it. You can't be an objective doctor if you even feel emotionally sorry for the "hypothetical" kid with spina bifida.

The worst is the kids who are in hospital because of "social" issues - the ones who have been neglected and malnourished and abused. I don't particularly feel like writing a lot about them at this time... suffice to say, the thought of these children keep me awake at night. They deserve a blog post of their own. Perhaps, at the end of the rotation, when I have more time and when I've gotten a few glasses of red into me, I'll wax lyrical about them.

The paediatricians are all great. Lovely people, compassionate, and passionate about what they do. Of all the doctors that I have seen, I think the paediatricians have been the least cynical and the least tendency to be flippant or facetious. But, less than a month into the rotation, I already know paediatrics is not for me.

Oh yeah, my last rotation was obstetrics and gynaecology.

O&G is definately not for me, either. And the less said about it the better.

Friday, March 26, 2010

Sida's bucket list

A bucket list is a list of things you would like to do before you kick the bucket (ie - die). It comes from the movie The Bucket List, starring Morgan Freeman and Jack Nicholson. Love the movie, one of my all-time favourites.

My bucket list:
- Have a child/place/treatment/small country named after me.
- Try a wine that had been cellared for over 40 years
- Write a book, get published
- Compose a short symphony
- Lead a small group of people into some unchartered territory
- Proclaim my God before millions, in some way, shape or form
- Be someone's favourite doctor.
- Be someone's favourite person.
- Witness a miracle in someone else
- Give someone a gift they have never experienced before
- Save someone's life, twice.
- Fall in love.

Thursday, March 18, 2010

Applying the Reasonable Person Standard to Coffee

Imagine yourself, bleary-eyed, at about 7:30am, when, contrary to all reasonable human practices, you've already been up for about two hours, and somehow you find yourself standing at the entrance to the hospital, about to start your day. Or, perhaps, it is about 3:30 pm, lunch was a distant dream, and home seems even more distant.

You need that coffee.

You realise that coffee isn't the elixir-of-life, it is only the elixir-of-the-next-hour-or-so. But anything will do.

So, you trudge to the nearest coffee shop... or, if you have enough volition, you might search your brain to see which is the nearest cheapest coffee shop. Because, after all, you are a student, and by definition you are very poor.

"What would you like?" says the girl at the counter, in a painfully cheery tone.

You search your brain for the right words. What was it that I wanted? Um, the thing. Comes in a cup. Taste bitter-ish. Coffee. But that's not good enough! What do I usually say? Come on, she's starting to look at me funny...

"Regular-skinny-flat-white" you manage to mumble, the words blurring together. Flat white? Or latte? Oh well, too late now.

When the regular skinny flat white comes, of course, she charges you for much more than the price you expected, and you see why. It is huge. You look frantically around the counter, and you realise that "regular", to this coffee shop, actually meant "medium", and "medium" means very large. You should have told her you want the "small", if you want a "normal" size coffee... but it is all too late now. You take the coffee away, glad for anything. And you drink it all, because no poor medical student throws coffee away.

For the rest of the day, your hand shakes when you put needles into someone, you need to run to the toilet every few minutes, and your head feels distinctly antsy.

It is the opinion of the writer that "regular" ought to be regular. There should be a standardised sizing system for coffee. "Regular" means the small in some shops, but large in others... while still other shops name their smallest size coffee "grande"... it is very confusing, and I am usually already in a confused state when I call upon a coffee shop. All I want is a reasonable sized coffee to reasonably kick start my brain. If I had enough brain cells to figure out what "size" that corresponds to, then I wouldn't need to buy a coffee!

Thus, a law ought to be passed in parliament. The Reasonable Person standard already exists in law; it holds that: each person owes a duty to behave as a reasonable person would under the same or similar circumstances. It could be applied to coffee thus: the size of the regular sized coffee should be the size of what a reasonable person would order, under reasonable circumstances. If it doesn't make a lot of sense to you, don't worry, that's law for you.

Either way, something needs to be done!

Wednesday, March 17, 2010

New blog

I have started a new blog... the address is http://aboveallwonders.blogspot.com/

I will still continue to write in this one, but there will be some distinctions between the sorts of things I publish here, and the sorts of things I publish in the other blog.

I just wrote an explanation of why I started a new blog in the other blog... so I won't repeat myself here. If you are reading this, I hope that you will check out the other one too, once in a while. But I realise that the other blog will not be to everyone's taste.

Not that this one is to everyone's taste, of course. But you know what I mean.

Friday, February 12, 2010

Ophthalmology and ENT

Well, I just finished my brief spell in the specialties of Ophthalmology (the study of the eye) and ENT (Ear Nose Throat, or Otolaryngology to the Americans). Two weeks in each. The word "Specialty" I suppose implies that it is special, and indeed it was.

Ophthalmology was interesting, in its own strange way. I spent the first week feeling like everyone was literally talking in a different language... The complexity of the subject can be appreciated simply by the fact that, in any textbook of ophthalmology aimed at primary carers and medical students, there are only a few conditions that does not carry the recommendation: "Refer to ophthalmologist urgently".

ENT, on the other hand... was... well, let's simply say, special. Let's look at it this way. When I looked up, in a textbook, a chapter called "ENT emergencies", the first one was "epistaxis", or nose bleed. Now, I am aware that very severe nose bleeds can be a big deal, but it really was a bit of an anticlimax. Considering ophthalmology had in its list of emergencies such impressive-sounding things as "sudden loss of vision", "sudden onset diplopia" and the like... a nose bleed really seems sort of humourous. And so it was for the rest of the specialty. ENT is indeed a complex subject (in its own simple sort of way), and interesting, in small-ish doses. But sitting in the ENT clinic listening to complaints of ear infections and runny noses just seems oddly humourous. It is no defect of the specialty or of the department that lead me to feel rather bored, I am entirely convinced it is due to my own ineptitude toward anything surgical. As the registrar kindly said: "You did a good job feigning interest for two weeks".

I do feel a bit apologetic for this, because a medical student could not have asked for better clinical teachers. As such, I have no taste for surgery, just as a person may have no business sense or no ear for music.

Anyway, without further ado, and continuing the tradition of previous terms, here are some "quotable quotes" of Ophthalmology and ENT.

By the way, if you are wondering why I am blogging so much this week... it's because I have finished my ENT assignment early, and have been "let off the hook" from attending a few clinics and surgeries... and thus with a reasonable amount of time on my hands. Next week I will be in Critical Care, and possibly not so care-free.

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Ophthalmology Registrar: "Dr K is good with eyes." (I giggled at this... he's an ophthalmologist, of course he is good with eyes! On the other hand, I suppose it is the highest praise you can give to a doctor... to be simply good at what he is supposed to be doing.)

Ophthalmology Registrar: "Why go watch the cataract surgery? You could go to the library and watch a cataract surgery on Youtube, and you get a running commentary on it. Don't bother, it's boring."

Ophthalmology Registrar: "Do you know anything about the retinal changes in macula degeneration... no, let's simplify this. Do you know anything about macula degeneration? Who am I kidding, you're a med student. You wouldn't know anything. Let me explain."

Ophthalmology Registrar: "Have you considered specialising in Ophthalmology, Sida?"
Sida: "No."
Ophthalmology Registrar: "That was rather emphatic."
Sida: "Oh... sorry."

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ENT registrar: "This patient presented with a severe case of runny nose."

ENT registrar: "Most salivary gland tumours arise from the parotid gland. Do you know where the opening of this salivary gland is?"
Sida: "It makes saliva... so in the mouth."

ENT consultant: "I'm a microsurgeon and I can't type."

ENT consultant: "Where does the rash in Ramsay-Hunt syndrome appear?"
Sida: "Um... we are in the Ear Nose Throat department... so I'm going to guess the ear, nose, and throat?"
ENT: "Amazingly you are right, except it doesn't appear in the nose."

Med student: "So why are you cutting little squares?"
ENT consultant: "Because little circles are too hard to cut."

Surgeon: "There appears to be quite a bit of bleeding."
Anaethetist: "Well that is because you keep poking it with your sharp instrument! I can promise you if you stop poking it it will stop bleeding."

Surgeon: "We will be finishing early today because our last patient cancelled the surgery."
Sida: "What a shame."
Passing nurse: "Your smile gives you away."
Sida: "I don't know what you are talking about..."

(And this following one doesn't really have much to do with either specialty...)
Med student: "Ooo, what's that book you are reading?"
Sida (shows her the cover): "The Confessions of St Augustine."
Med student: "Sounds interesting. Who wrote it?"


Tuesday, February 09, 2010

Sida is evil

Today, the registrar asked me to grab some pathology containers to put blood samples in. I didn't know which one to get, so I grabbed all of them...

He only needed two, so I was left with 4 empty pathology tubes.

I was too lazy to take them back to the storage room... so I just put them in my pocket.

They went from my pocket to my bag, from my bag to my table... and now, they are in my fridge.

"Sida, why are they in your fridge?" I hear my dear readers ask.

Well, you see... as I was standing there in theatre, feeling tired and dreadfully bored, it occurred to me that I could have a lot of fun with these containers. Imagine my dear mother's surprise and disgust when she opens the fridge and sees some pathology containers - all containing something yellow, purulent, and offensively mysterious. The thought was too sweet to dismiss, and I couldn't wait to get home.

Unfortunately my 11 year old brother was home when I got home too, so I had to let him in on the secret... but he promises to be a good sport.

In one tube (the EDTA tube), I put a mixture of Apple-Guava juice, cooking oil, and a drop of soy sauce. The oil separated nicely from the juice, which was again separated by the tube additive... I gave it a good shake... and, voila, I'm a genius. I created a purulent fluid resembling sputum.

In another, was a mixture of squid sauce and soy-sauce (giving it a lovely brown). In yet another, was the good old fashioned tomato sauce, mixed with some water.

I would have LOVED to take a picture of the containers for your entertainment, but unfortunately as soon as I'd done all this and put the items back, my mum's car drove in the driveway. I quickly put them all into a small plastic dish, and pushed it into the fridge, behind the capsicums. I will take a picture later, maybe, after mum goes to sleep.

I really hope she discovers it when I'm not at home - then, her imagination will run REALLY wild, she will be totally disgusted, but she won't be able to question me. Being a dutiful mother, she will assume that it is something work-related, so she won't throw it away. In fact her imagination will run so wild, she will imagine all sorts of disgusting things, and she won't be able to even TOUCH it. That is the evil dilemma I have placed my mother in - she will be disgusted to the core, but unable to do anything about it.

But now I have a problem. Say if she found it when I'm at home... what explanation should I offer? It should undoubtedly involve something to do with bacteria, or parasites. But why would the specimen be in MY fridge, rather than in the hospital? I need an explanation that is plausible, not too far-fetched, but never the less disgusting. And, if possible, I would like to convince her to keep it in the fridge for at least a month.

Any suggestions? Please help! Comments welcome.

Thursday, February 04, 2010

Sunday, January 24, 2010

The voice of God

The following post is dedicated to my dear Sister in Christ. I can feel your earnestness, your pure heart of faith. Trust in Him, and He will not fail us.

A sister at church today asked me an interesting question. To paraphrase, her question was:

"So often, I hear people's testimonies, saying: "Jesus told me..." or "I heard the Holy Spirit tell me...". I've asked God so many times to tell me something, to give me a revelation, but why do I get nothing? I just want a word from God, a directive, to lead me on the right path. It seems like so many other people have heard God's voice speaking into their hearts. If God speaks to me, how do I distinguish that from my own thoughts?"

Below is a summary of my response to her. Of course, it didn't sound as good as this, because I was driving at the time, had no time to gather my thoughts, and my brain was already full of the summer midday heat and plans for the afternoon.

A disclaimer: the following perspectives were formed out of my personal experience. If anyone has any differing opinions I'd be glad to learn.
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Live by faith, not by sight.
Firstly, although it is great to receive revelations from God, to hear His words resounding in your life, we should always remember the directive is to "live by faith, not by sight" (2 Corinthians 5:7). Our faith should be founded on the salvation and life we have received, and on the covenant that Jesus has established with us who have believed in Him. Our faith and trust in our Father should never be based on what we can and can not subjectively "feel".

Doubtless, He is always at work, always working in our lives. Just because we can not hear Him, it doesn't mean He doesn't love us, and it doesn't mean He is far away from us. Looking at the years that passed, the difficulties I have encountered, I know that God was carrying me through the tough times. But I also recalled times when I felt like Job when he said "If I go to the East, He is not there; if I go to the West, I do not see Him" (Job 23:8). In my case, and in Job's, we come to realise that God is here, whether we see Him or hear Him or not.

Expect the unexpected
If humans have five senses - sight, sound, touch, smell, and taste... imagine the number of senses God has! God speaks to us and guides us in many different ways - through a passage in the Bible, a line of lyrics in a song, a few words of encouragement from a church brother or sister... and countless other ways that we don't know. Just because someone else testified that they heard God's voice audibly telling them what to do, doesn't mean you necessarily have to be blessed with the same thing! And just because you were not blessed with the same thing as the person next to you, it doesn't mean you are not blessed. God works in us according to His ways, and His ways are perfect, albeit mysterious and unpredictable.

The same goes for spiritual gifts... just because you see someone else speaking in tongues, doesn't mean you have to! God doesn't necessarily give each person the same gift.

Receive the Word
"All Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness, so that the man of God may be thoroughly equipped for every good work." (2 Timothy 3:16)

In looking from hear from God, surely we need not look further than the Bible! Though we may be searching for personal revelations, through the Word we can see the ancient promises God has made with you and me. Having problems that you are searching for guidance about? Perhaps your problems are not so dissimilar to what regular people like Abraham, Jacob, David, Moses, Peter... Their revelation is also yours.

"But his delight is in the law of the LORD, and on his law he meditates day and night." (Psalm 1:2). It's unbelievably important to read Scripture, to be familiar with it, and even to memorise verses. I can not count the number of times when, in great pain and doubt, and during a great struggle with Satan, God brought to mind a verse in Scripture that I'd read. It is mostly through His word that God reminds me of His love and great mercy.

Meet Him in the silence
1 Kings 19 tells the wonderful story of how the prophet Elijah witnessed the glory of God passed by. He first felt a powerful wind, then an earthquake, then a fire, but God was not in the wind, nor the earthquake, nor the fire. Lastly came a gentle whisper, and it was through the whisper that God spoke to Elijah.

It is often said that prayer is 10% talking and 90% listening. I must admit that in my prayers I tend to spend much more time talking, and impatient to wait for that gentle whisper. Too often I know that I wish for the great awesome revelation of God, the sort that comes in a great wind, or a great earthquake. A typical day in my life is full of noise (full of sound and fury, signifying nothing, as Shakespeare would say). If I don't take some time each day to wait on Him in silence, would I hear His gentle whisper, over the sound of alarms, buses, traffic...?

Seek first His kingdom and righteousness
"But seek first his kingdom and his righteousness, and all these things will be given to you as well." (Matthew 7:33). I love this verse... our directive is so simple. We don't need to worry about much else - we need only be concerned, on our part, with seeking His kingdom and His righteousness. Love the Lord our God with all our heart, mind, and strength. As for other things - like ministry, spiritual gifts, revelations - these will follow suit, when the time is ripe.

Recognising the Shepherd's voice
"I am the good shepherd; I know my sheep and my sheep know me" (John 10:14). How do we recognise His voice, over the storm that is in our heads, over all our thoughts, and the hubbub that is our life?

I remember when I was a new Christian, probably only a few weeks old, I asked that question to my mentor. He thought for a bit, then looked at me and said: "You will know."

Over the years, I have come to see a few patterns in the way God speaks to me. Invariably, His word always bring salvation, possibly from something that has been binding me for a while. His word brings refreshment, awakens me, and always guides me back to Him. How do I distinguish this from my own thoughts? I can't really describe it, like my mentor says... I just know. I guess mostly, they were too wonderful to be my own thoughts.
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If I thought about it really hard, I can probably think of some other things to add... but mostly it would variation on the above, possibly with different bible verses. If you have been patient to read this far, I do thank you for your attention. *bow*

Tuesday, January 12, 2010

Innocence Lost

A rare comment today by a rare reader lead me to read through my old blog entries. (Apparently, my writing has improved! Actually, I think I agree.)



I came across the poem I wrote for my brother last summer - Looking At Stars. I really like that poem, it really captured the my feelings at the time. A year on, though, so much have changed...



Innocence Lost

Here we are again, under the starry skies
Sitting on a ledge, the waves crashing below us
You ignore the stars, the sea and the foam,
You put your arms around me protectively: "sit closer, or you'll fall," you said.

What happened to your childish wonder?
What happened to your questions about the Pleiades, Orion, and The Dog?
You no longer notice the heavens; those lights no longer draw your attention.
Your only focus is on earth, the darkness, and whether your sister will fall.

I can see the man you are trying to be,
I can see you trying to be older and stronger.
You ask me questions I can not answer, that no man can answer,
All those questions of "Why", "wherefore", and "how".
It breaks my heart to remember you are only eleven...
I would pluck the stars from the sky to see your eyes light up again.

I'm sorry it happened this way,
I'm so sorry I wasn't there to protect you
I'm sorry for everything that I am not,
I'm sorry for everything that I am,
For everything that you deserve, that I couldn't give you.

There is One who is greater than me,
One who will always be there for you.
He is enough for your every need, in every way,
He whose sandals I am not fit to carry
Will lead us home when we are lost in the darkness.

I pray that you learn how to be a child again
With a childish wonder, a childish faith.
A child of God, protected, and loved,
Like a son of the King of Kings.

Wednesday, December 30, 2009

Totally awesome music maker thingy

I found this really totally awesome music maker thingy on the web - it's perfect if you're bored or if you have a few minutes free... it could occupy you for 5 minutes or 5 hours!

It's this music maker thing called inudge, instructions on the site, totally recommend you trying it, whether you are a music maestro or a maestro wanna-be (like me).

Here's the link, with one of my creations: click

Try it out, comment with the link to your own creation!

Tuesday, December 01, 2009


I'm on holidays now, horray!

I've had quotable quotes from the Surgery and Psychiatry rotations, but GP was mostly quite sane. I had a great time at the practice I was posted to; that's probably why I don't really have any snide comments to make. Actually, the practice probably deserves a separate blog post. That's for another day; right now I can't be bothered thinking about medicine-related things.

My brother all of a sudden showed interest in coming to church. I'm not actually all that sure why. Maybe he's older now and wants to meet more people; or maybe he might figure it's time to grow spiritually as well as mentally and physically. Already 11 years old and weighing in at 40-odd kilos, he has done plenty of growth in the latter two departments.

So last Sunday, while the church was reciting the Apostle's Creed, he suddenly said to me: "Who's Pontius Pilate?". So, I decided to teach my brother all about the bible. They say, in medicine, that if you can explain difficult medical concepts to a child, then you understand the concept well enough yourself. Well, I'm going to try teach my brother elementary theology... which is an amusing thought, because I'm not even sure if I understand all of it myself. But oh well, we'll see. Watch this space.

I was going to start with Genesis, go through the patriachs, then to Exodus, etc... but I suddenly thought, since it's nearing Christmas, we should learn about the Christmas story. A nice easy topic to get started with.

So on Sunday night my brother and I went through the first two chapters of Matthew and the first two chapters of Luke. We read one paragraph each, stopping every now and then so I could explain to him what words like "Christ", "Messiah", "Immanuel" meant. Then I told him about the social and political background of those times, and why everyone was waiting for a messiah. It took about an hour and a half, and I had his captive attention all this time. Quite impressive, quite exciting, and quite scary. It's like God giving me a blank book and I get to fill it out. I just pray I do it well... not only the teaching part of it, but also just setting a good example in everyday life.

Skip forward to Monday afternoon when he came home from school. I was half-reclining in a very uncomfortable position yet unable to move, because I was beating the boss stage of Space Invaders on my brother's Nintendo DS. The giant alien-thingy had turned from pure green to pewter, so I knew I was getting somewhere.

My brother came in and announced he won the backstroke race in his swimming carnival at school... and also mumbled something about his uniform, or something like that. (I lost track of what he was saying when the bastard evil space alien took my first life.)

Then he said, in a half embarrassed, half awkward tone: "Sida, I wanted to say something to you..."

"Ahuh." I said. He was probably going to ask me to buy him something that he knows I will say no to. The space alien somehow grew a shield and was shooting me with lasers.

"... I wanted to thank you..." he said, awkwardly.

"... yes...?" I said. I had figured out a way to penetrate the shield, but at the cost of one more life. My thumb was starting to feel a bit sore. Why do they make buttons so small on these things?

"... I wanted to thank you for teaching me the bible." He finished.

I was lost for words for a while, partly because I was surprised, partly because I wasn't sure what I should say now, and partly because my space ship had acquired a laser and the alient had turned red. I wondered whether I should make a big deal about what he said, or just take it lightly. I also wondered if the red meant the thing was about to die soon.

That decision was made for me when the space alien took another life. The bastard! I only had one more left!

"That's ok, honey, it's my pleasure, really. We'll do it again tonight." I said. "Die, you stupid thing! Arrgh!"

The alien took my last life. I shifted in a more comfortable position as the words "Game Over" flashed onto the screen. I peered at my brother, but he had finished all he was going to say on that topic. "I'm hot. Can I go for a swim before starting on my homework?" was the last thing he said before he turned away.

So much for setting a good example in everyday life. Oh well. I guess you can't make a big deal about some things.

Thursday, September 24, 2009

Quotable quotes from psychiatry

I just finished my psychiatry term, my final psychiatry exam is tomorrow... therefore I should be cramming (and indeed I will continue cramming in a minute). But, here are some quotable quotes... watch this space, more will be added when I have time.

Patient: "You know, our planet is already destroyed, we are not living on Earth at the moment, we are living in the Australia planet. Earth was destroyed when the Germans put a nuclear bomb under the South pole."
Sida: "The bastards!"
Patient: "I'm part German, you know..."
Sida: "Oh, I'm sorry."
Patient: "Yes, I'm part German, part alien."

Patient (to Sida): "Excuse me, excuse me, can I buy some sushi off you?"

Patient (to an Asian psychiatrist): "Your tablets are turning me into a woman. Australians are not easily fooled, doctor!"

Sida: "Do you have any special abilities? Like, are you unique and different from everyone else in any way?"
Patient: "Well... do you trust me?"
Sida: "Uh... uh... yeah?"
Patient (stands up): "Stand up and I'll show you!"
Sida: "Uh, no thanks, no thanks!"

Patient: "Yes, I've been diagnosed with heaps of things. Schizophrenia... Bipolar... Psychosis... Mania... Crazy... Looney... Fruit-cake..."

Psychiatrist A: "In spite of the nature of our work, I don't think I've ever heard of a psychiatrist being killed by one of their patients."
Psychiatrist B: "Wasn't there a case in Perth a few years back?"
Psychiatrist A: "Well, the killer was another psychiatrist. Does that still count?" I'm thinking... get me out of here!

Patient: "No, I don't take drugs."
Nurse: "So, if I took your urine sample to the lab for a urine drug test, I wouldn't find anything?"
Patient: "Weelll... You will probably find it's positive for cannabis. But I can explain that..."

Wednesday, August 05, 2009

An acrostic

I had the idea to do this while reading the Psalms and noticing how many psalms are acrostics in Hebrew...

It was actually a lot harder than I thought.

An acrostic for the Lord
Acrostics feature heavily in the Bible,
But they can't be easy to write.
Creativity, vocabulary, and wit... none of which I possess.
David wrote them in Hebrew... I wonder if that makes it easier?
Enough meaningless banter, let's get down to some serious acrostics...

Father, let Your will be done
Great and mighty works, just as the days of old
Here on Earth, as it is in heaven
In my life, let Your will be done.

Journeying through my pilgrim, let Your light guide me,
Keep me on Your path, the straight and narrow that's so hard to find,
Let me know You walk with me, remind me when I forget
May my path and my journey bring glory to You,
Now and forever, every moment belongs to You.

Open my ears that I may hear Your words
Pry my eyes open that I may see Your will
Quieten my heart that I may feel You move
Rest my soul - because I know, You speak with breathless whispers...

Sometimes the darkness surrounds me,
There is nothing but silence.
Unveil the silence, the darkness and the emptiness
Vindicate me from the voices that condemn and accuse, and the
Whirlwinds of doubt, depression, and devastation - they will not wear me down.

(X is too hard, why do we even HAVE that letter anyway!)
You give me strength, purpose, life and liberty,
Zeal and passion, rest and peace.

Sunday, July 26, 2009

Surgery: the rotation that was

It's been a while since my last blog post. My last post was on exhaustion... and I've been too busy (or indeed too exhausted) to blog since. Add that to the fact that I'm in 3rd year medicine... and what conclusion to you arrive at? Obviously I must be on the surgery rotation!

Well, I just finished my surgery exam on Friday, and let me tell you, it was a pain in the bum. In more ways than one, since somehow there was way too many questions on anal conditions. Those surgeons are really anal. Haha. Bad joke, but I couldn't resist...

My experience in surgery was coloured by the fact that my previous two rotations were not so cool (the less said of those rotations the better), and the fact that I had the added stress of resitting an exam I didn't pass from the previous rotation (I would like to say it wasn't my fault, but they all say that, don't they?). In surgery, amazingly, I found consultants who were willing and indeed seemed to enjoy teaching, registrars who were insanely busy but not too busy to spend a few hours a week teaching some students, and residents who treat you as one of their own. Best of all, was the fact that they all had that same sarcastic sense of humour as me. During my first few weeks I felt like I struck gold! Not only were the consultants kind and patient, they actually laughed at my jokes instead of allowing an awkward silence to fall.

So below is a sample collection of the quotable quotes from our interactions. I hope they bring a smile to your face, although I do fear that some of the jokes may be a little... subtle.
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Mum of a 12 year old: “He won’t listen to your advice, he still plays football despite his crook knee.”
Surgical registrar: “Well look, it’s up to you. I don’t mind if you play football, because then there is a high chance I’ll get to operate on you again, and I like operating on kids, it’s good practice. Shall I book you in for surgery now, or would you like to wait til after the game?”

Dr A: “So, Sida, as I am removing this thyroid, what am I trying to avoid taking out?”
Sida: “The… para… thyroid?”
Dr A: “That’s right, the parathyroid. What does the parathyroid gland do?”
Sida: “It… makes… para… thyroid… hormone?”
Dr A: “Yes… but what happens when we take out the parathyroid?”
Sida: “The patient wouldn’t have any parathyroid hormone?”

Dr A: "So, Sida, were you born in Australia?"
Sida: "No, I was born in China, then I lived in New Zealand for a while before moving to Gold Coast. All the shady places, in fact."
Dr A: "Haha... where did you live in New Zealand?"
Sida: "Northland"
Dr E: "I'm not aware of anything of note up there...?"
Sida: "That's fair enough, there probably isn't."

Nurse: “What size gloves do you wear? I'll get some for you.”
Sida: “Size 5 and a half, thanks very much.”
Dr B: “5 and a half! You can’t do orthopaedic surgery in size 5 and a half gloves! You need to learn to stuff your gloves and tell people you are a bigger size!”
Sida: “Is that what orthopaedic surgeons do?”

Sida: “Dr B, I’m rostered to join you in your surgery this afternoon.”
Dr B: “That’s fine. Just make sure you are nicely sterile when you come.”

Dr C: “I asked my resident after my surgery whether the surgery was the most fascinating intriguing satisfying thing she’d ever seen. She just flat out said no.”
Sida: “Do you think she didn’t pay enough credit to your awesomeness?”
Dr C: “What do YOU think, Sida?”
Sida: “Well, I think she was wrong. You should always sweet-talk your consultants, for one thing.”

Dr D: "Now that's what I call BBB - beaucratic bovine byproduct."

Dr D: "If you give him a plaster like that you will drive him to drink."

Dr D: "This sort of surgery is very difficult, very very difficult. This is something I would never attempt myself... I'd give it to my senior registrar." (As a background, the senior registrar is the highest level trainee under Dr D.)

Dr D on lawyers: "Have you heard the legal definition for the word 'reasonable'? A barrister explained to me while I was on the stand as a witness, and I told him it was illogical and circular reasoning. That bastard argued with me for half an hour about it, until the judge finally stepped in and told him: 'the Doctor is right, from a scientific perspective.' They are all nutters, the lot of them."

Dr E: "Doctor F, we have a medical student in our midst today. For the sake of the student, and for mine too, could you explain what you just said? "

Dr G: "Urology is interesting. It really is. Honestly. How do I convince you that urology is interesting?" Can't be done, I'm afraid.

Dr H: "Everyone is scared of us orthopedic surgeons. It's because orthopedics is hard, they don't know it, but we do, and they know we are cranky neurotic nutters. But you guys don't need to be scared, because it's all very simple..."

And the best quote of all:

"You know those elite athletes who win gold medals? They all say the biggest thing to conquer is yourself. The swimmer may be really tired at the last second, but he know he's got to push through, it's the last second that counts. Keep pushing, Sida, mummy believes in you." - my mum in response to her 22-year old daughter crying to her on the phone like a 5 year old.

Sunday, June 14, 2009

Sida’s five stages of exhaustion

STAGE 1: Fatigue

This is usually sooner or later accompanied by hunger. Sida experiences an increasing awareness from her brain and muscles that the day has dragged far too long. If accompanied by hunger, Sida will repetitively say: “I’m hungry. Did I happen to mention I’m hungry?”

STAGE 2: Irritability

Sida progresses on to this stage if her body continues to be denied of physical rest and food. Signs of irritation are subtle in Sida, but usually manifests in the form of flat, dry sarcastic comments or jokes. The more irritated she is, the less sense her jokes and comments make. When Sida starts quoting Shakespeare (“Now is the winter of our discontent”, or “Tomorrow, and tomorrow, and tomorrow…” ) it is time to evacuate the premises.

The length of time Sida spends on this stage depends on how the day went – if the day was a generally OK day, this stage does not last long.

STAGE 3: Delirium

Having felt tired and hungry for so long, Sida has come out the other side somewhat numb. She is chatty and giggly, but her chatter makes no sense, and no one can understand what she is giggling about. As she fights to keep her eyes open, some have likened this stage to being tipsy.

STAGE 4: Depression

Sida’s sense of justice wakes up and she can not believe that in this late hour she still can not go to bed (or, in some cases, still has not had the opportunity to eat dinner). Waves of self-pity and frustration crash upon this fragmenting irrational brain, and she will sob to herself quietly, lamenting the life she has chosen, and completely without the energy to actually get up and get some food and get into bed.

STAGE 5: Insomnia

Finally in bed, Sida tries to command her brain to switch off, but it punishes Sida for the overwork by refusing to obey. She is left lying there thinking about all the irrational things her brain wants her to process, ruminating all the decisions she made, and regretting that last cup of coffee.

Monday, February 16, 2009

The slightly drunkish med student talks about ward rounds

I'm not drunk. If I concentrate, I can still say "cyanide and thalidomide" without the syllables blurring together... at least, I can if I concentrate. Besides, I can type. Right?

You go through a whole day muttering swear words in your head. Everyone acts so patronising... the doctors, the patients, even the other medical students. Patronising in such an unhelpful way. Is it because I'm a girl? Or because I am young? Or because I am physically smaller? Or because I am an Asian? Or a combination of the above? Life on the wards is no fun for a young female short Asian medical student, maybe. But I'm not even all that short. Before I went and did medicine, I was a bloomin allied health professional, dammit, and they would have paid much more respect to me back then. Grrah.

So when my flatmates come home, having had a rough day on the mental health unit themselves, and having gone and bought some alcohol... the only fitting thing to say was: why not? They poured me a big glass of this really bitter thing. I poured a lot of it down the sink when they weren't watching... I hope they don't find out, I think that stuff is expensive.

The doctors on ward round stand around the patient's bed... one consultant, one registrar, two interns, three medical students... sometimes, one nurse. That's four doctors, three doctors-in-training, and a nurse. Eight medics. The doctors flip through the charts, murmur to each other, look at the progress... looking down at the creature before them like it's an intellectual puzzle, the way you'd look at a crossword or a jigsaw puzzle. The effing intern prims her hair, writes in the chart with her careful neat handwriting, stamps the chart carefully and proudly (are you proud of your stamp, which says "Doctor"? Live up to the title, you highly decorated waste of space), having never said a word to the person whoes chart she is writing in. The patient is not a person: he is a puzzle to be solved, a medical enigma, with a set of blood test results and obs. If the puzzle is solved, the person need not be dealt with. Once, when the consultant left to answer a phone call, the group huddled around a patient, and then proceeded to talk about another patient (of course never mentioning names), completely ignoring the one before them. I was angry enough to really make some enemies in there.

A few of them (the patients, that is) I have spoken to before; heard their stories... the son in university, the business for sale, the failing heart, the aging spouse at home awaiting for them to return home. When we enter, like a mob from the movies, they recognise me: the one person in this 7-doctor posse who has spoken to them for more than 2 or 3 sentences. Their eyes light up. "Hello, love", they say. "Yes, of course I remember you."

Today a patient was going to be discharged... he was finally allowed to go home to his wife and help out with the financial burdens of the family. He shook the consultant's hand. "Thank you doctor." he said. Then he turned to me: "And thank you." I hadn't done anything. I'd just sat down opposite him, and we only talked for about twenty minutes. A patient shouldn't need to thank a 3rd year medical student. I was angry to the point of tears.

Of course I have much more to complain about. The older medical student (older in age, not in training) who treats me like a primary schooler, despite the fact that he's never worked in health before... the doctors who think that if they ignore medical students then they will magically train themselves into doctors... the whole f***ing establishment, who thinks that if you sell your soul then maybe, just maybe, you will be considered good enough.

You could say that I am negative because I've been drinking. But you could also say that I've been drinking because the outlook is very negative. Now I think about it, my last drink was quite a few hours ago anyway. I'm not even sleepy anymore.

I guess I will make an attempt to do some reading, another little droplet to fill the vast emptiness that is my brain... then go to sleep... and wake up to another brilliant day on the ward.

Sunday, January 04, 2009

The wind and the waves

The wind and the waves, they work so well together!
The waves, they toss my little boat about like a toy,
They spash against the sides; they laugh at my fear,
Like a gang of big playground bullies, they wall up around me,
There is no escape, no mercy, only salt and fear...

But the wind! The wind is much more subtle...
It howls past my ear, laughing and taunting,
I can feel his cold breath on my shoulders, my back,
His words and his laughter pierce my mind.

"You fool," he laughs, "you have no power against us,
You will fall into the murky depths, you are mine! Mine!
Your prayers go no further than this ceiling, your call does not go to the Above
For you are small, and He is big; you are tainted, and He is pure
With one glance He sees the heavens and the earth, the vast spaces and the flowing galaxies;
You are but a speck in His peripheral vision; He hears you not. Where is He now?"

"Look around you - you've been here before! Let the ghosts of the past flit through your mind,
Let the images replay like a silent film - do not deceive yourself!
Havn't you been here before? Are you not going around in circles?
Ergo, the future holds much of the same! There is no hope, no hope, no hope...
What are you holding on to?" laughs the wind.

I crumple in the corner, I can't block him out
His words and his laughter circle my mind,
Day in, day out, there is no respite, no rest for the wicked
Out of these depths I called to You, I called Your Words into mind:
"For I know my redeemer lives..."
"My grace is sufficient for you, for my power is made complete in your weakness..."
"The Lord is my portion, therefore I will wait for Him..."
"I am the good shepherd..."
"Your rod and your staff, they comfort me..."

I hold fast to Your promise, not because I am a person of great faith...
But because I have nothing left, because without You, I am alone in this storm
Though I can't hear you, Lord I know You are sovereign...
You are the creator and author,
The wind is Yours, the waters is Yours
This boat is Yours, this journey is Yours.

May this journey take me to higher ground,
May this cycle end today,
May Your power be made complete in my weakness,
May Your light shine into this darkness,
May Your promise be fulfilled in me,
May Your will be done, on earth as it is in heaven.

Friday, December 12, 2008

The Cedars of Lebanon

Last year, a good friend of mine invited me to his church's 14th birthday celebrations. They hired the UQ centre, and it was like one big party (the praise and worship had break dancers etc), followed by a sermon. At the end, my friend asked me whether I wanted to stay back and meet some of his friends. I wasn't extremely keen, because he wasn't the greatest person when it comes to introductions, and because I was starting to feel hot and tired... but once I saw the gigantic creamy chocolate cake they had on offer, my decision became simple.

Introducing myself to people proved rather difficult, because it was crowded and noisy, and because I'd forget people I met only seconds after I meet them, producing the rather embarrassing situation of introducing yourself to them twice. My friend stood by looking around and not being particularly helpful. (Or at least that's how I remembered it... hehe) But anyway, I digress.

"Hi, my name is Sida" I say to one guy.
"Zita, nice to meet you" he says
"No, it's Si-da"
"Sita! I'm sorry..."
"No no, SI-DA... like the Cedars of Lebanon"

At this point, my friend next to me started chuckling and looked at me sideways, but wouldn't tell me what he was laughing at. I decided not to press him, partly because it wouldn't work, and partly because if he told me I probably wouldn't have liked it anyway. What's wrong with the cedars of Lebanon? Big, tall, fragrant tree mentioned in the bible for its majestic loftiness, used to build temples and palaces. After I got home I decided to look it up in the bible to make sure.

I found that, while the bible exhalts the cedar tree in some places, there are much more passages humbling it. The latter made me feel uncomfortable and I decided not to introduce myself to Christians as the cedars of Lebanon again. All this was tucked away in my mind, until yesterday, when I realised that this tree teaches me an important lesson in this stage of my life. I guess that's the long-winded introduction to what I'm about to write about.

The Cedars of Lebanon

The cedars of Lebanon is a type of pine tree, and its many endearing qualities make it an important tree historically, culturally, and in Judaism and Islam. Light in colour, fragrant in scent, strong, hard, and resistent to insects... the Lebanese people are so proud of their tree, it's their national emblem, and occupies the central position in their national flag.

In the bible, the cedar was used by Solomon to build the temple, as well as his palace. (In fact, the bible records that he called his palace the Forest of Lebanon.) Additionally, there are many verses that praise the cedar tree for its strength and majesty, and if something was to be described as very grand and beautiful, it was described (frequently in the Song of Songs and the Psalms) as being like the cedars of Lebanon.

On the other hand, there are also many verses that describe God humbling the cedar, and showing His power and righteousness. Psalm 29:5 says: "The voice of the LORD breaks the cedars; the LORD breaks in pieces the cedars of Lebanon". In the books of Isaiah and Ezekiel, the prophets compare proud nations to cedars, arrogant, cruel, and standing tall above other trees, but eventually coming to a crashing burning end under divine judgement. The myriad of verses that show the cedar in this manner made me never want to say "Sida like the cedar of Lebanon" again.

Now I think about it, it does show two aspects of my life and of my psyche. On the one hand, some of my qualities have been able to be used by God in His church, and though I am nothing like the cedars, I do believe that God has shown His grace and glory through what I do. But, of late, slowly and subtly, these same qualities have made me proud, and of course, with pride comes insecurity - the constant niggling feeling that you're actually not as good as you think you are, and the fear that others may find out. I know that this pride could eventually lead me far away from God, focussing not on Him but on myself and what others think of me. My ministry would eventually become meaningless, leading to one thing - crash.

Deuteronomy 9:17-18 tells us that the good things we are gifted with or have acquired, are not just because of our ability, because even if it were, the mere ability comes from God. I may be blessed in some respects, but I should never fool myself into thinking that these are my own work... I'm on God's journey, my abilities were given to me from Him, in order to serve Him. There is no appropriate attitude to take except for complete humility and servitude to Him and to others.

I'm amazed at how much I wrote... actually on this topic right now I could go on and on and on... but it is nearly midnight, I have a stomach ache, it's so hot I can hardly breathe, and so sleep seems like a very good idea right now.

Monday, December 01, 2008

Looking at stars

Looking at stars with you this summer night
We lie facing the heavens, the dry, warm ground on our skin
The insect repellent incense fills the air with smoke and magic
"What's that star there?" you ask

I take you to a world of nebulas, clusters, black holes and supernovas,
A world so far away in space and in time, your mind cannot grasp,
And your eyes open wide with childish wonder
Somehow, you think I can name every star in the sky.

I take you to ancient Greece, where the minotaur roams,
Orion boasts with his club, and the Big Dog guards the night sky
I bring out my telescope, and show you
Pleides, and Jupiter's companions: Io, Europa, and Ganymede
And the dark side of the moon, swallowing the light

One day you will grow up, and the moon's pock-marked face will no longer allure you,
You will no longer be interested in the twinkle of the Pleides,
Or wonder what Orion is dreaming of tonight
But until that day comes, you have reminded me
Just how simple, how beautiful, and yet, how mysterious God's creation is
Do you see His glory? Can you hear His song?

Sleep now, little brother, sleep and dream
Dream of the light dancing across the infinite spaces
Of the serene nebulae and the laughing galaxies
Dream of Jason and his argonauts, of Orion and his sword,
Dream the dreams of innocence and childhood
Before the world awakens you.