superbugs - our own nightmare.

Picture the following scene, possibly from a movie, or some TV drama:

"You mean to say, we have created a superbug? It's resistant to everything we've got?" asks the doe-eyed young assistant (or not-so-intelligent colleague, possibly acted by Jessica Alba? She has doey eyes...). Of course, she is stating the obvious that we all have figured out by now, but these films must make its point super-clear, even if it is at the cost of making the "intelligent" female side-kick super stupid, and severely patronising its viewers.

The doctor/professor/researcher has a haunted, melancholy look. "Yes." he says, very simply. The camera zooms in on his brilliant yet troubled face, his haunted eyes... (I'm thinking Eric Bana, but that's only because I like Eric Bana, although I suppose, to be realistic, one must have an actor who is suitably aged. Michael Douglas perhaps fits the bill, is he still acting these days?)

The "superbug" then spreads through the hospital, on to the staff and relatives, and into the community. Amazingly, our heros are not taken ill. The pair work together, in a race against time style of thing. They figure out a solution of some sort, everyone leave the state, perhaps? As they work together, they fall in love (ew, Jessica Alba and Michael Douglas? No way. Who goes well with Eric Bana? I'm a bit behind with Hollywood stars.) However, as they are implementing their solution, one of them reveals that they are also ill with the superbug... In a self-sacrificial manner, this person isolates himself from everyone and dies the painful death. The film is ended - many millions died, but one of our heros survived (which is all that matters in these movies, really), and the bug is contained (this last bit is necessary, otherwise the movie would not be about a superbug but about the apocalypse).

The "superbug" is some sort of science fiction idea, an idea that we can all toy with, an idea that goes well with a comfy seat and popcorn and a night out. But it is actually very real.

Everyone knows antibiotics are wonderful weapon against bacteria. We all know the impact of the discovery of penicillin has had. But few know that bacteria can become 'resistant' to antibiotics. How does this happen? Put simply, in a population of bacteria that can be killed by antibiotics, there may arise some that are resistant to the drug. This resistance can come from gene mutation (which is very rare), or from the bacteria sharing genes with one another (microbiological sex, as my lecturer puts it. He even showed a picture of bacteria-porn.). The susceptible ones are killed off by drug A, but some are left which are resistant to drug A - these ones grow and prosper and make our patient ill. So we use antibiotic B, which, again, kills most, but leaves some resistant ones. We then use drug C, and D, E, F, G... until, hopefully, all has died away. But what if that doesn't happen?

If that doesn't happen, whatever bacteria we are left with, are resistant to drugs A, B, C, D, all the way to G. If we used every single antibiotic we had, and there are still some bacteria left, which continue to populate our patient and make him ill, then we would have our Superbug.

When antibiotics first became available, we didn't appreciate the possibility for resistance to develop. So antibiotics were administered lavishly, indiscrimminately, providing ample opportunity for resistance to develop. And - you guessed it - it developed.

MRSA - Methicillin-resistant Staphylococcus Aureus is one such bacteria (aka "Golden Staph" - I have heard it being called "multi" resistant too). It is resistant to all penicillins, which makes it a very bad thing to have. We have one antibiotic - Vancomycin - which can kill this bug, but this is not used liberally to avoid resistance. Some strains are already showing resistance to Vancomycin (called VRSA), but this is currently rare. MRSA is not uncommon - even endemic - in some hospitals. What happens if VRSA ever reaches such proportions? The situation would resemble the above scenario somewhat - like a movie, but with uglier characters. This is scary. A fellow medical student said that it gave him night sweats (to which we all chuckled nervously... I think he might have been joking.)

What can we do about it?

Health professionals now avoid multi-resistance using many means. One of them involves killing the bacteria as quickly as possible - not giving it time to develop resistance (think maximal dosage and using 2 different types together). Also, we try to give drugs that are as specific to the bacteria as possible, and to limit the usage of very effective drugs that bacteria easily develop resistance against. As you would have figured out by now, the more liberally and carelessly we administer antibiotics, the more likely resistance is. So one very important way to control resistance is to educate the public about antibiotics. Which, I guess, is what this entry is all about.

The crux of it is, antibiotics are not the "solve it all" solution some people believe them to be - particularly for colds and flus (often of viral origin anway). One fellow student joked that at the pharmacy where she works, they have an ongoing joke - "With this drug, you will recover in 48hours. Without it, it will take 2 days". Many people go to doctors, feeling ill, but not wanting to slow down and rest, and demand antibiotics. Our tutor said that in her practice, they had an education campaigne where brochures were printed to educate their patients about resistance - and antibiotic prescriptions went down by 25%.

What else can you do, apart from not demanding antibiotics? Well, for one, don't take someone else's antibiotics. If you are prescribed with them, take them exactly as recommended - don't stop just because symptons have subsided and certainly don't "save some for later". Aside from that, general good sanitation would be good too.

That is all I have on this subject thus far... I feel better now, even if no one reads my blog and I didn't actually end up "educating" anyone.

The Sequel

This is the sequel to the strange story of how I came in contact with Medicine Royalty. I'm not going to reiterate the story here. If you don't know the story, go to: http://supersida.blogspot.com/2007/03/funny-thing-happened-other-day-youd.html for the prelude.

Following on from last time... I got home today, and I saw the bunch of mail on the dinner table. My mum waited until I'd gone through every single envelope and fallen down on the chair devoid of energy, before she casually mentioned that The Package had arrived and was in my room. OK, I know you're all just twitching with anticipation, so I will skip the bit about how excited I was, the speed at which I ran upstairs, the momentary confusion caused by my not finding it despite instructions from my mum, yelling from down stairs.

The Package held the following: a sheet of commemorative Australia Post stamps signed by both Nobel laureats, a "Les Prix Nobel" by Professor Marshall (signed with "Best Wishes to Sida"), a copy of a cartoon depicting the ingestion, and a note from M.

This week I'm studying Diabetes, and I'm also reading about the psychosocial effects of diabetes and chronic illness in general. (It's more interesting than I thought it would be - I will write about it some other time). So I'm feeling kind of guilty now. What are the psychosocial effects of fame? What are the psychosocial effects of generations of medical students learning about you? Of people writing in their blog that they think you're crazy? I flipped through the "Les Prix Nobel" (I'm yet to find out what that means), and it seems the decision wasn't that crazy after all. I feel really guilty now... One thing we learn - the pen is mighty, the mind may be weak, but a pen in a weak mind is still mighty. (Actually we already know this when we read some of the opinion articles in papers...)

I used to collect stamps, as a pre-teen, so when I looked at the stamps, I thought - wow, this trumps everything I've got. I've got to hand this down to my future generations... I will start my own family heirloom, my own family legend. They'd better appreciate this. I'm going to force the lot of them to study medicine - my sheet of stamps will not pass to a bunch of non-medicine-appreciative people... plus it's the only way I will have a family legend...

Somewhat embarrassingly, there is a rumour going around the 1st years that someone wrote a sycophantic article about Professor Marshall.

Funny thing happened the other day, you'd never believe it...

I was going to write about this after I finish my John Flynn Rural scholarship application, but I realised that, at the rate I'm going, I may never complete those selection questions. So I'm going to blog now, and do the "more important" things later.

So anyway, I refer to the entry I wrote about 2 weeks ago, on Professor Barry Marshall and peptic ulcer. http://supersida.blogspot.com/2007/03/if-i-ever-meet-dr-barry-marshall.html Basically in this entry I called Professor Marshall, the famous Nobel Prize laureate, insane. I never actually think that anyone ever reads my blog... I see the counter go up but it rises very slowly and I'd always thought that it was due to people coming across it by accident.

So imagine my surprse when I recieved a comment to that blog entry, which arrived to me via email. "Interesting article!" it said, "Please email M at xxx@helicobacter.com for more information."

I broke into a cold sweat on the spot. You can imagine my shock, horror, and fear. This woman obviously knew a lot about this subject. She was probably from information group, or research group, or support group, or something. I'd stirred up a bee's nest... Craaapp, I've put my real name on that thing. Crraapp, it's even got my photo on it. Sida, you stupid stupid girl. But it's ok! I'll just delete the whole blog! They'll never find me!

So anyway, I sent a short, tentative email back: "I can delete, or alter the post if you deem it inappropriate..." I was just short of saying: please don't sue me.

So anyway, M replied with (take a big breath...) "I am Assistant Manager of the Office of the Nobel Laureates – Professor Barry Marshall and Dr Robin Warren. Barry was pleased to read your blog and has asked me to contact you to get a mailing address as he would like me to send you a signed gift from him."

My first reaction was purely relief. I am not going to get sued. My parents can keep the family house. I do not have a black mark against my name. Then... "ARRRGHH! Barry Marshall read my blog! ARRGGHH! ARRGGHH! How embarrassing!!!"

So anyway, that pretty much concludes my tale. As suggested by a friend, I checked out www.helicobacter.com just to make sure the domain name exists, then replied with my address, with quivering fingers. M replied to thank me for supplying my address (thank ME?)... and to hope that I am going well with my studies, and hope that I enjoyed my H. pylori subject. I'd like to reply, but I'm not sure about the etiquette regarding these things. Does she expect a reply? Is it polite to flood the Assistant Manager of a nobel prize laureate with grateful emails? I decided not to. (But, if in case you are reading this, M... It's certainly more interesting than skin, immunology, or anorexia nervosa. I have already ruled out dermatology, immunology, and psychiatry...)

I told my friends, and the general consensus is that this is a great thing. I'm not so sure, though. Do I really want Barry Marshall reading about my strange misadventures? There is a lot of speculation about what the gift might be, too. Some (non-medicine) friend even joked that I should be careful when opening it, as it may contain a culture of bacteria. I jokingly suggested to a friend studying law that she should do the same about Justice Kirby... but she said that it had already been done.

If you're looking for the comment posted by M, you won't find it. At her request, I removed it to hide her email address. But this really did happen! I didn't make it up, nor did I dream it...

Ok, I'm going to get back to my John Flynn application form now. I would like to post an entry about what I think of selection questions posed mainly by large organisations, but since my blog is actually being read, I will simply say that I find them rather tedious. On that note, I am a hardworking, flexible, adaptable, proactive person, who would strive to be a significant contribution to rural communities...

(Sida's note: for the final chapter of this exciting trilogy, click here)

Corrections (and apologies)

In my post about Barry Marshall, I called him DOCTOR Barry Marshall. He's actually PROFESSOR Barry Marshall. Apologies to the Professor... (Actually I have a funny story about that, but I have promised myself to finish my John Flynn scholarship application tonight. Will regale my exciting tale some other time.)

My previous post, written last night, about the assumptions people make about me, was written when I was very tired and when I was in a very bad mood. You can probably tell this, both by the tone of the post as well as the horrendous spelling and grammar, and general poor style. Apologies to everyone who read it.

Top 5 assumptions not to make about me.

For those people who meet me for the first time... Just because I am an Asian and I am studying medicine, it does not mean:

1. That I am smart. Please don't assume I'm smart. And don't tell me I'm so smart because I do medicine. That is a fallacy.
2. That I work very hard, and put marks above all else.
3. That my parents made me do it, or I'm in it for the money, lifestyle, power, or guys. Or that I am in it because I'm Asian and it's one of those innate Asian things. I consider the sacrifices of doing medicine great that none of the perks forementioned are worth it (even the guys).
4. That I know everything.
5. That I know why your head/back/shoulders/joints/abdomen are achy these few days. Do not ask me why you're tired, or why you're sleeping more/less than usual. Know your own body, go to a doctor when necessary.

I met some people recently who I'm so sure thought that they knew me after just knowing what I study. It is very annoying, such that these days I only tell ppl that I'm a "student" and only say medicine if asksed.

Mint tea + lemon tea = EEEWWWW

Let me start from the beginning. Today, after church, I was approached by a friend who said that he needed a lift home. Sure, I said, I just need to go buy some tea (vital study-aid). So I run off to Woolworths.

Milk? Where do they keep the milk? Yogurt, I suppose I got to buy the yogurt too... Where on earth is the tea I usually buy? Why are there all these different types? Cookies-and-cream tea? Interesing... Lemon Twist? That sounds good. Oh, there it is, good old Lipton Green tea, packet of 50.

So, being acutely aware that someone is waiting for me, I grab what I see and run back to church to find that this friend's brother can drive him home after all. Ok, that's fine.

Until about 5 minutes ago, when I made some tea to keep myself awake (or to let my mind fool my body). I knew as soon as I opened the packet that it didn't smell right. Crap! It's green MINT tea! I can still remember the last time I had mint tea, it was at bible study and it was so gross the host poured it all out. And I bought 50 bags of it. Acutely aware that this tea cost money, and that money comes from working like a trained monkey every Saturday, I decided to make it anyway. Can't be that bad, right?

So here I am, watching my tea cool, smelling its tooth-paste-like odour. Then I had a flash of what I thought at the time was genius. The mint can be neutralised if I add something to it, right? Something with a stronger flavour. The first thing I saw as I looked around my desk was a packet of jelly beans. Don't be stupid, no one puts jelly beans in their tea. Then I saw the Lemon Twist, which I also bought...

Mint + lemon. How to describe it? In colour and texture, it is like any other tea. The smell is also not unique - it is the smell that wavers around the elderly and very ill patients in hospitals. The taste... sour, like the taste you would get if you ate an under-ripe berry. It resembles neither lemon, nor mint, nor tea, but seems to be an entirely new and newly offensive flavour. There is, inevitably, the after-taste of toothpaste. I had not disguised the toothpaste flavour, just added another dimension to it.

In fascination, ever the scientist, I drank the lot, wondering its effects on my body. Of course, it's just tea, I'm being fanciful, but you'd be too if you could smell and taste the thing.

Usually when I drink tea, my room smells like it, and it usually smells quite good... jasmine, or lemon, or just plain green tea. Today, my room smells like bed-ridden old people.

If there is one thing to be gained, this concoction will certainly wake me up. The question lies... what does one do with the other 49 tea bags?

"Should I tell them" by Shaun Groves

"Should I Tell Them" by Shaun Groves (from the album Invitation to Eavesdrop) is my current favourite song. I love the lyrics, even though it's not entirely applicable to me. The "What should I say to them? What if I'm failing them?" question is always on my mind when I communicate to others about my faith... and also, what if I'm failing Him? So when I do communicate to others about my faith, I am often, like the singer, just plain afraid. I feel like I am making a big speech, a speech that has a life-and-death effect.

On the other hand, I don't actually think that I am the perfect example of all He can do in a life.

Walking with you is not without hazards
Trippings this traveler's curse
Price paid for falling is more than my stumble
In a world that is watching and waiting for words

But I listened when You said to go
And I set out in spite of my fears
About truth mixed with my imperfection
And the question of what to say when I got here

And now that I'm here
Should I tell them that
You are the one who has made me
And saved me and set up a home there inside
Should I tell them that I am a perfect example
Of all You can do with a life.
What should I say to them? What if I'm failing them?
What should I tell them tonight?

Now don't get me wrong I'm thankful to be here
With this song to sing and a spotlight on me,
But lately I'm wondering if you are mistaken,
If you're seeing all of me there is to see.

Cause on every face I detect
The same questions I've posed to you
Like do you speak through the imperfect
Are we too dirty for your light to get through?
I want your light to get through.

What should I tell them when
They're thirsty Lord
My cup is empty Lord
Come and lead me here in this place
Cuz I'm honest, yeah, but I'm unprepared
And I'm just plain afraid

Lyrics copied and pasted from www.christianlyricsonline.com

If I ever meet Dr Barry Marshall...

Everyone knows what peptic ulcer is, right? (Actually right now I could write a whole essay on peptic ulcer, it being the case for this week). From memory, peptic ulcer had a small mention in the film Intolerable Cruelty. Basically it's an ulcer in the stomach or earlier part of small bowel, similar to the ones we get in our mouthes. As a disease, even the ancient egyptians had it.

In the early 1980's, a pathologist at the Royal Perth Hospital named Robin Warren noticed a bacteria found in the stomach of gastritis sufferers. This idea was considered outlandish, since everyone knows that the strong acid in the stomach means no bug could live there. Warren was soon joined by Marshall, who was looking for a research project. Together, the pair tried to culture (ie grow) the bug, but to no avail, until Easter came around. During the Easter break, there was a staffing shortage, and the culture was left for an unusually long time... and the bacteria grew. (Haha, love the Australian culture where everyone goes away during Easter and even the most important medical research is put aside...)

Once cultured, Marshall's job was to prove that these bacteria caused ulcers, which went against the commonly held notions of the time. In frustration, in 1984, he drank a culture of bacteria himself. Eventually, he became very sick, developing gastritis (which would have turned into ulcer if he left it). He then cured himself with antibiotics.

The road to gaining widespread recognition of the cause of ulcers was still a long one and it was 10 years before it was officially recognised, but his point has been made. And today, 20 years on, we at medical school are taught that H. pylori bacteria causes 70% of gastric ulcer and 90% of duodenal ulcer. Of course, it was a great discovery, as we can now treat ulcers such that there is a very low chance of recurrance. People's lives are improved. The need for surgery is lessened. Chances of complications reduced. Medicine at its best.

But, seriously, what kind of person drinks a culture of bacteria to see if he gets ill? My PBL tutor was working as a physiotherapist at the Royal Perth when this was going on, and she said everyone thought he was nuts. (Which is why he drank the culture, I guess.) Didn't anyone try stop him? ("There's got to be a better way!") And it would certainly have tasted awful.

Barry Marshall sounds quite insane. Which means, of course, if I'd ever met him, I would be too chicken to tell him I think he's insane. I would be reacting along the lines of - "Um, (giggle) um, um...big fan, read all about you. (nervous giggle) Um. Can I have a photo with you? Can I have your autograph? So... uh... uh... what did it taste like?"

Oh, and by the way, if you didn't know, Barry Marshall and Robin Warren won the Nobel Prize for medicine in 2005. According to my microbiology lecturer, Marshall had problems getting his research published because he didn't have ethics approval to test the culture on someone (ie himself).

(Sida's Note: to go to the sequel to this story, click here.)

Updates, I guess

I havn't written here for a while, but there isn't much to update on. Just hanging in here, trying to stay on top of it all, but failing miserably. Was going to write an entry about indigenous health before, but then realised that i really knew too little about the issue, and it's a lot more complex than I had ever imagined.

Agreed to a girl at church to do some 'service' on Sundays, on a whim. I agreed because I do enjoy to serve and because I hate to think that my studies interferre with my service to God. (Even though I know and He knows that it's already happened). It's going to be ok. God will provide.

Considering very very seriously a placement at the end of the year in a rural hospital. Don't have enough money to go overseas. Those two-doctor hospitals sound pretty cool, do lotsa cool things like suture and cannulate and intubate and deliver babies and get abused by drunken people who fall over and hit their heads.

Gave a friend some tips about the Gamsat today. She thanked me perfusely, and said she will try her best to follow my advice. crap. Obviously I hadn't put enough disclaimers in. Now I just hope she does well.

That's all for now. Helicobacter Pylori awaits me.

Success without compromise

This sunday I was listening to a Christian radio station while driving to church, and I heard a guy praying for the audience. It was a very nice prayer, asking God to bless the listeners and guide them and let them be a light for the people around them (ie non-christians).

Towards the end, he prayed that the listeners may have "success without compromise".

This stuck in my mind and I have to admit when I first heard it I was a little taken aback. Of course what exactly he meant by "success without compromise" I'm unsure of. But when I first heard it I thought it meant that we may have success (in the normal sense of the word, meaning worldly success) without compromising our Christian values. I guess it could also mean the other way around: that we be successful in a spiritual sense (pleasing God and being a light to others) without compromising our worldly needs.

Why did this statement offend me slightly? It's what we all would love to have, right? The best of both worlds - to be successful in life without compromising our conscience. I admit that I would love to have this 'success without compromise'. Currently, I spend a lot of time studying and the amount of time I spend serving others, or even just participating with others in religion, is compromised. That offends my conscience. I try to maintain my bible reading and prayers everyday but sometimes I am just so tired I only read a few lines of the bible before I know I will need to shut it or I will sleep with my head on top of it (and ruin my lovely expensive leather-bound silver-trimmed blue-ribboned bible). Success without compromise, yes, that would be nice. (I am being honest here...)

But to pray for it? I feel it is almost like saying to God: "Yes, I love you, but I also love the world, so please don't make me compromise my success in the world."... or "The worldly things are so important to me I don't want have to compromise them". Of course, I am not saying that following God necessarily means that we have to be poor, in fact, there is a school of thought that God intends for us to enjoy the fruits of His creation. But to pray to God that we don't have to compromise?

As I said before, I am currently in a state of 'compromise'. If I go to all the extra youth group activities, I don't study, and I fall behind, or at least feel like I am falling behind. If I don't, I feel guilty. I have never prayed for Him to take that guilt away, I just rely on his mercy and understanding. I also try to make my learning experience an act of worship, reminding myself of the ingenuity of His creation when I study. I try to remind myself to do mini-prayers throughout the day (something I read from a Philip Yancey book). I pray for Him to forgive me, to open my mind to his creation, and to allow me to be a good doctor one day. But never 'success without compromise'. The idea of it itself is strange.

I am in the process of finding in the bible all the bits that indicate our relation to the worldly, and how we are to enjoy this 'success'. This is an interesting topic, so I will probably consult my bible study leaders and the bible itself, and post here with the results. This is an appeal to whoever is reading this: what do you think of this "Success without compromise"? Perhaps I misunderstood the guy. All comments welcome. Even if you know me personally. Really.

Miserere Mei, Deus

I changed the "Sing for the moment" to "Miserere Mei, Deus", the great chant by Gregorio Allegri. Laudate Dominum by Mozart is beautiful, but the sound was of a poor quality and besides it's time for a change.

I don't usually make a blog entry about changes in music and in 'verse of the week', but I feel I must explain myself, seeing as I think that Gregorian chants written in the 16th century is probably not everyone's cup of tea. But be open minded, listen to it, with the volume nice and low. It's a beautiful piece. (Keep listening to it, there is a wonderful soprano bit in the middle.) I don't usually like chants myself but I make an exception for "Miserere Mei, Deus". (When the going gets tough, there are two circumstances in which I can have a good cry, one is listening to this chant, the other is sitting infront of the piano (which I play badly) when no one else is home).

Miserere Mei, Deus means "have mercy on me, O God", the first verse of the Psalm 51 (which is also a beautiful piece). Allegri wrote it for some part of the long complex Catholic mass, and some pope along the line liked it so much he declared it must not be played anywhere outside of the Sistine Chapel at the appointed time. Transcription and copying of the work was forbidden.

The story follows that Mozart, at age 12, in 1770 (a few hundred years down the track), visited the Sistine Chapel with his father Leopald during Easter, and heard the Miserere. That night, on returning to his lodgings, he wrote the entire piece down from memory, returning later with it hidden in his hat to make minor corrections.

Ok, well, I just felt like sharing that with you. Next time I will put something contemporary on, really.

Medicine is crazy

Medicine, and everyone in it, or associated with it, is crazy.

I have been a med student for 4 weeks. A good proportion of my lecturers and tutors is crazy. The course is crazy, the workload is crazy. The other students are crazy. The immune system is crazy. Everyone, and every thing, is crazy. Which can only mean one thing - that I'm crazy, and everyone else is normal.

1. The teaching staff is crazy. Many of them fit into stereotypes: eg- the hard-core pathologist, the confusing ethicist, the nurse who says, as a joke, "next time, bring chocolates". But then, there's the pharmacist who went through the mathematics of pharmacokinesis in one hour. And the other pharmacist who told us that pharmacists are obsessive-compulsive-anal-retentives. And the PA hospital orientation lecture, taking place at 8am, just to tell us that there is a library there and that we need to be nice to the staff and patients. crazy. (At this point I must say, my PBL tutor is lovely.)
2. The students are crazy. They somehow seem to find it okay. No one feels like it's hard or overwhelming. Everyone is having a ball. Perhaps they are just not admitting it? Or is it just me? Next Friday they are having a "sports day", where med students dress up in scrubs and drink and get red dye over each other. Those crazy med students drink like fishes. How can they drink so much when there is so much work to do? Someone is crazy, and I prefer to think it's them.
3. The immune system is crazy, in a good, interesting, but crazy way.

The reason why I'm complaining so much on blogger is, I've realised, because I have no one else to do it to. The other med students are so on top of it all, when I ask them how they are finding it, they say "good, good", even if they don't have a science background. When I talk to my non-med friends about it, they just say to me: "Sida, you're smart, you'll be alright" or something along those lines. I know they say it because they don't know what else to say. But I don't feel smart right now, and I don't feel like I'll be alright, and when they say that, I feel like I'm going to crash and burn even more. I guess what I need is validation, someone to say: "You're not nuts, Sida. It's ok to feel like you're going to drown." (Oh boy, I've applied the communication skills lecture to myself... now I KNOW I'm going nuts.)

*sigh* So there we go, another complaining blog entry.

Um, I did have fun at microbiology last week. We were doing a gram-stain (which is supposed to go: purple mixture (forgot name) - water wash- iodine - water wash - alcohol - safranin). We put on the purple thing first, then the safranin, then realised the alcohol comes before the safranin, so we washed the safranin off, then alcohol, then safranin again. Then we (my lab partner and I) looked at the iodine and thought: where does this come in? When we realised, we washed our slide with alcohol again, and then put iodine on, and then safranin. The gram stain is supposed to come out purple or pink, depending on the bacteria on the slide... my partner and I were dreaming of how we might have invented a new staining method and be rewarded with a nobel prize, but when we put it under the microscope, it was just a slush of brown. When the tutor asked us how we were going, the response was unanimous - "Fine, fine, thanks."

My microbiology lab partner is a cool canadian dude with a cool accent and a neuroscience major. But he's bloddy smart. Everyone's so bloddy smart.

Oh, it's Chinese New year's eve. Happy new year, everyone who reads this. Living away from China, one doesn't get in as much spirit as one should.

my thoughts on 'The Secret'

Hmmm. Actually I'm finding difficulty thinking of a diplomatic, nice, unprovocative way to say 'it's a load of crap'.

To anyone who is unaware of what 'The Secret' is, it is the "law of attraction", which states (more or less) that the universe responds to your thoughts and the things you dwell your mind on. If you dwell your mind on positive things, things you would like to have or would like to have happen to you, the universe reponds to that and gives you positive things. http://www.youtube.com/watch?v=csiAsbPxmmY if you want to see a video on it.

The first time I saw it was on TV, channel 9 (or 7, I forgot). I didn't watch all of it, but I watched enough to get the gist of what they were saying (after all the so-called 'law' of attraction is very simple).

It's rather interesting, because we've always had a law of attraction, called "Murphy's Law". When they showed the guy thinking "I'm going to be in late, I don't want to be late" and then getting stuck in a traffic jam, I thought: that's the Murphy's Law! They stole Murphy's Law!

Also, interestingly, the Chinese have also always had a similar theory, and they called the 'positive' and 'negative' things 'qi', meaning literally air, but more aptly translated as 'energy'. A chinese would hope to bring good 'energy' into their lives by saying auspicious things to each other at New Years, and avoiding topics like illness and death (especially at the start of the new year). When my brother says things like "don't crash", he always gets growled at by my mum. Neither of my parents wanted to listen when I wanted to discuss the possibility of organ donation with them.

Of course, although this is interesting, it doesn't make it true. (The Chinese also believed in dragons and gods and buddas and demons and ancestor-worship.) There are truthful elements and preposterous elements to this theory. Let me go through the truthful elements first.

The "law of attraction" (I really hate to call it that, though) promotes positive thinking, which is good. It is true that quite often, if we say, for example, "I'm too dumb to get into medicine", then we probably won't. But I believe it's not because the universe responds to your thoughts, I believe that when you say "I'm too dumb", you are confirming it in your own mind and therefore have less motivation and set yourself up to fail.

Have you ever surprised yourself, though? I know I have. Countless times, I think "crap, I'm going to miss the train, I don't wanna miss the train, I'm going to be late for work," but I catch the train, or I'm not very late at all. When I did my Gamsat the first time, I thought I was going to get around 64, and I was feeling quite good. I got 60. Second time, I was more realistic, and thought for sure that I will get no more than 3 above my first score. I was very worried that I'd done worse the second time, it was my main concern. By the grace of God, (and I mean it) I got 71. 2005 I was on the 60th percentile (I achieved higher or the same as 60% of candidates), and in 2006 I was on the 96th percentile. If the 'law of attraction' were true, I should have gotten lower. Despite my high score, I was worried that I wouldn't get in. I'd mentioned in the interview that I would work during my studies, that I was Christian, and that I had no community involvement worth talking about ( I shouldn't have worried but I did). But I still got in, with a Commonwealth-Supported-Place.

It is difficult for me to refute the 'law of attraction' using logic and reasoning, as I am not a philosopher and have no experience/training in logic. I can only use the above example. But consider if the universe really did 'respond' to our thoughts and notions, does that mean it's personified? How does a physical entity such as the universe, in which we live, become personified? If the universe (or indeed any super-human entity) 'responds' to our thoughts and desires in such a indiscrimminate, mechanical, constant manner, such that we can manipulate it (and our outcomes), what meaning does that give our lives? A predictable mechanism controls our fates, we control that mechanism, but to what end? Perhaps we will achieve material 'success', but that is no longer nessecarily due to our endevours, only that we manipulated the universe. Anyone can do it.

Interestingly, in the film clip, they recommend you write down what you want, but start off with "I'm thankful for..." but who do we thank? The universe? I'm always amused when non-religious people say they are thankful.

And of course I cannot end a commentary like this without discussing my religious view. God raised up many people that did not have positive attitudes. The most famous is Moses, who thought himself inarticulate and clumsy, and was concentrating on the negatives of God's commands (that the task was so big and himself so incapable). One of our youth groups is named after Gideon, who thought himself small and weak but was used by God to be a mighty warrior and defeated a great army. (It is a favourite story in our church, and "The LORD is with you, mighty warrior." (Judges 6:12 NIV) is commonly heard in encouragement to young people. ) I do try to have confidence, and try to be positive (which, at times, is difficult), but not because of "The Secret", but because I believe that, ultimately, I am in God's hands. As much as I do complain, I do believe that God will take care of me. It's very unchristian of me to complain I guess. It's just that there is much to complain about sometimes...

This ends my commentary on 'The Secret'. I don't think I did a good job of explaining or rationalising a theory that I believe is illogical. But there it is. By the way, think_next, do I know you?

congratulate me

at library again. leaving now. It is 5 pm, I have been here since 9 am, and all except an hour (ok, hour and a half) of that time I was actually studying. Not procrastinating, studying. Not dreading or stressing, but studying. Woohoo...

I could probably do it for longer, I drank enough sugary tea to last me a while. But it takes me ages to get home, and besides, it's time to leave. I'm sure if I don't get up now my muscles are going to atrophy so much that I'm going to be stuck here.

quick post

I am currently at the library (again). This is a quick post before I get up and leave. I feel as if I should be staying here for longer, I havn't actually accomplished much in the hour and half that I've been in here. But I'm starving and I'm sure that if I stare at this immunology text book any longer I will burst into tears, which will be very embarrassing.

Yes, you heard right. Immunology.

There is something about immunology. I just look at it, at the diagrams labelled with things like "CD2b3b5b" (or whatever) and there is this thing that happens in my mind. I think it's like a survival mechanism, that just says: "Sida, this is much too complicated. Leave it. They sell great pizza on this campus somewhere."

Now we know Sida won't be an immunologist when she is a grown-up doctor...

Does stress and studying immunology and waking up at 6am make one less attractive? I'm almost sure it's doing that to me. I have blue bits under my eyes and my skin has gone a funny colour. In the past, it used to go grey when I study like this, and I used to scare myself when I look in the mirror because I look like a dead person from a horror movie. This time it's different, my skin being darker due to my holiday to the Whitsundays. Instead of being a deathly pale grey, it is a sallow sort of yellow that makes me look like I'm in the late stages of some liver disease.

As I really don't have time and energy for boys at the moment, I guess the fact that I'm currently repulsive to boys is not such a bad thing. I am curious, though. I wonder what I will find if I look up "attractiveness" and "immunology" (or just "stress") in Pubmed, the online medical journals database. Some one, some time, some where, probably did a study on it.

Where Sida becomes a student again and tries to resist despair

You may ask: since Sida is in medicine, which she's wanted for a long time, why does she need to despair?

I am in my 2nd week of medicine, and they (the educators, that is) say that these two weeks are the easiest, it gets tougher from here.

There is no easy way to express the plight I'm in. I can only give an example. Last week, in my Problem-Based-Learning group (a sort of study group, PBL for short), someone mentioned baroreceptors and chemoreceptors and everyone knew exactly what they were. I was the only one who had never heard of them before. The everything goes so fast, everything just swishes around in my brain in some sort of incoherent soup. And people assume that I'd know some things since I did indeed have science-health background. (But it's radiography! It's like photography with physics!)

But I'm resisting despair, mainly because I'm sure if I work stubbornly at it the way I work stubbornly at everything, it will work out. I am taking a rest from study, it is 4pm, and I have been in the library for 3 hours. The incoherent soup is (somewhat) less incoherent and certainly less daunting. Besides, I do like learning and I find the human body interesting, so if I get over the fact that everyone else seems to know more than me, I may actually enjoy myself. (This really sound like I have a pride issue doesn't it? Hm, perhaps I do...)

I never did consider my income to be large or even significant, but now I do feel it. Going from working full-time, to working one Saturday every 3 weeks (3 hours over 3 weeks) does definately put a strain on my finances. But I did get a call from the rival company today, so I may get some more work.

Um. Surprisingly, I have run out of things to complain about. Except that the air-con here in the library is really really breezy, it's freezing in here.

I can feel the library (and the abundance of medical students around me) doing me mental damage. I think I will go home now.

On recieving free stuff

Yesterday, we got 'attacked' by about 5 or 6 different Medical Indemnity Insurance companies, advertising to us and welcoming us to the profession (are they even in the profession, to be welcoming us? Who knows). What did they want? They wanted us to register with them for free as students, so we can learn about their company, and perhaps when we graduate and they no longer offer free services, to spend a small fortune on their company.

I counted 8 free pens, 4 cloth bags, 1 highlighter, 1 ruler, 1 case study CD, 2 drink bottles, countless lollies, note pads, lanyards, and ID clips. There were also draws for stethoscopes and textbooks. All this for a bunch of Med students who are on the third day of their career.

While I did enjoy this bombardment of smiling reps and free stuff, it did get me thinking. Suppose these were pharmaceutical companies. Suppose they gave their stuff to us so we would recommend their drugs to our patients. Suppose they gave it to our educators, so that they would teach us to use their drugs.

I know there is a big contention about this, and the issue is an interesting one. Firstly, everyone gets free stuff all the time, but marketing is everywhere and we develope a degree of immunity to it. The only time that I use fabric softener is when I recieve it free in the mail. Just because I have a free pen from company x it doesn't mean I will nessecarily use their products. But it does mean that I know this company and it will come to mind, and if their products are competitive then I will use them. I believe that this is not just me alone, but most of us have some degree of immunity to marketing.

Recieving free pens from companies does not constitute a bribe as such. They can not possibly hope to persuade us to use their products or services just on the basis of a pen or note pad.

I once read an article from a GP somewhere in the states (or somewhere else, can't remember). He works in a tiny practice that really has no money for expensive software and equipment, and he uses a prescribing software that comes at a low cost from pharmaceutical companies, but it is loaded with ads, and is programmed to make choosing certain brands easier. He says that it's not that he supports these companies, but an alternative software has been made unaffordable.

On the other side of the issue, some research does show that free merchandise alters doctors' judgements. I would suggest that it is because the doctors are more aware of the company that they choose it, rather than because they got the free pen. But as long as it is affecting their judgement, that is bad. Doctors should ideally research and know the best and cheapest drug for their patients, but inevitably there will be ones who don't, and will use ones that they are familiar with (ie the company name that is also written on their notepad). It would annoy me if I found out that my doctors' judgements were affected, however subtly, by a company, and similarly I would be annoyed if my educator's judgements were affected.

I'm at the end of what I want to say, and I still havn't come up with a conclusion. It's an interesting issue that I will follow and contemplate during the rest of my education and career. But I rest easy, for today at least, in that I only accepted free stuff from insurance companies and not pharmaceutical companies.

Where Sida attends Orientation, and ponders the ramifications of being a Med student

It was the first day of uni today. It was alright. (For those readers who just tuned in, I am talking about the Bachelor of Medicine / Bachelor of Surgery program at UQ)

The orientation talks were presented by the various Professors and Doctors and Chairs and Heads. It was all a little mind-boggling, just the titles themselves. Each of them congratulated us for getting in, told us what a good decision we'd made, and some pretty much hailed us as colleagues. There was some talk about what the different strands are all about (Clinical skills, public health, ethics and professional practice, and biomedical science). But a great deal was said that went along the lines of: "If you have any concerns, just realise that you're not alone, and you can come to [me/student support/your peers] for support." It was nice to hear the Heads and Chairs offer themselves to us, but also rather daunting. Is the course really that bad, that such a big deal is made about support and counselling? (Yes, this is how I think when I am in a cynical phase, which I suspect I am in right now.)

Much was said about how difficult this course is, and how it's going to be a long and difficult year. Actually, not a lot was said about it but it was certainly repeated a few times. The Head of School said "It's a long and difficult year which leads into another long and difficult year which leads into 2 difficult years of clinical practice" and I thought, you might as well add: "which leads into a long and difficult career". I realise now that I probably need to cut out some church stuff. Currently I attend Saturday afternoon youth group and Sunday morning service, and there is Wednesday night bible study too, to commense whenever our leader can negociate better work hours. I can't bear to part with any of them really. But if it came down to it, I suppose I will sacrifice Saturday afternoons. I also plan to work some weekends too. I get a headache just thinking about it. I need to plan, to rationalise, to be organised, and to work efficiently. Everything that I'm not.

It strikes me how people act when I tell them I'm a medicine student. Oh, wow, they say. You must be so smart. I have difficulty figuring out how I should act when people do that, so I just smile. It is enough that my parents brag about me, but I noted something strange this sunday. People at church are doing it too. This Sunday my bible study leader did it, and it's the second time someone from church paid me a great deal of praise to a stranger in front of me. My achievements are really just nothing, but I must admit it makes a great story, and, told the right way (with the appropriate pauses), it makes people say wow. (But the same trick is done by the 'current affairs' shows like Today Tonight, it doesn't make whatever dispute they've got showing worthwhile.) But when you tell people you do medicine, and they say wow, how do you deal with it? I want to say "actually, it's just that I'm too stubborn to give up. And God."

Speaking of God, I thanked the guy at church yesterday, the guy who showed me Isaiah 30:18. I didn't say anything, just "thank you for showing that scripture with me" and he said "That's ok" and tapped my shoulder in a knowing manner. It was as if he knew, which he couldn't have. I wonder what God has been telling him.

Some notes to SuperSida readers

Just a few quick notes.

1. I am quite happy to discuss things like the medicine course, the admissions process, God, and quite a few other things that I may write about. But mostly, when I write about my personal problems, I just did it to get it off my chest. Please don't discuss them with me, particularly if you know me personally. If you know me then you'd know that I will be fine. Please don't embarrass me by mentioning my blog to me.
2. If you do want to be of assistance, just be forgiving if my mannerism is a little dry or cold or humourless or abrupt or cynical, or if it appears that it takes a great effort for me to smile. It's not you, it's me.
3. Please don't embarrass me by mentioning my blog to me.
4. Please don't embarrass me by mentioning my blog to me.
5. Please don't embarrass me by mentioning my blog to me.
6. Please don't embarrass me by mentioning my blog to me.

Um. I think that's it. You get the gist. Happy reading.

Where Sida considers wrist-slashing and solace is found in God

Actually, I didn't really consider wrist-slashing. But it was an attention-grabbing title, yes?

No, I know my anatomy far too well to wrist-slash. The image of the tendons and reticulums and superficial veins of the wrist (rote memorised in Anatomy) has stuck to my mind. I can imagine myself applying razor to wrist, thinking: "Is that the tendon of my palmaris longrus I'm going through? It would be, it's the only one not within the flexor reticulum". Actually even that wouldn't be possible. I am far too much a coward.

The suspense must be killing you. I must disclose, now, what I am talking about.

It was a desire to turn inner pain and converge it into something physical, a physical pain that would be easier to bear, a physical pain that is almost tangible, a physical pain that a panadol (or two) could dull. It also stemmed from anger, although who the anger was directed at was uncertain. There is no one to get angry at, and yet I am angry. There is no one to punish, to yell at. Only an inner couldron, toiling and bubbling, as Shakespeare would have said. (This is good, I will record this feeling, one day it may help me to work with others in a similar situation when I'm a doctor)

She said to me, "You are my strength." And I felt like yelling. I am not your strength. Don't you think this affects me too? I have been watching all these years, all my life, silent and stoic. Yes, I listened silently as you moaned to me all these years, all your troubles that I neither wanted to hear nor should. But this affects me too, I am hurt too, and I am no strength! Don't lean on me! I'll show you how 'strong' I can be! I will do something weak, something stupid, and you will take notice, and realise how weak I can be too! I'll take up drugs, I'll slash myself (well, maybe just prick my thumb a little) and run away and get pregnant!

The source of my problems: one word: parents. I won't say any more on this, since I don't know where to start and I don't feel like talking about it. Only that it's been this way all my life, when I first had memory, when I could recall my mother telling me (in a moment of anger) that it was all my fault. (But, thick as I was, I was too smart to believe it. I had considered the events and circumstances and knew that I had nothing to do with it.)

So it was also a desire to punish someone. Possibly my parents, who rarely considered the impact on me, since I was always a quiet and submissive child. (Unlike my brother, who has the whole family in his grip). Or perhaps (this shames me a little, but it did occur to me) God. You love me? Well watch me do THIS! NOW you will take notice!

I was quite tempted by the idea of it, but just the idea of it. I will never execute this idea, like many other ideas, because of sheer cowardness. But the fact that I had these ideas and were tempted by them disturbed me so I called my best friend. I didn't tell her much, only as much as I wrote here. I feel a little sorry for her, because I remember how awkward I feel when people talk to ME about such things. I know I should talk to a religious friend but I havn't got one close enough (which is really my fault, I hadn't really 'opened up' to anyone). Anyway, she said that people looked up to me. "I look up to you, Sida. You're a Med student". I would have believed her if it weren't for the med student bit: she does law and I know that she'd never look up to me because I'm in Med. But she also added that I have a younger brother, who, in such times, would look to a strong adult.

Damn. Yes God, you have me trapped. I have to be strong now. Help me, give me some of your strength.

I didn't pray much initially during this time. What to pray? God know the plight I'm in. My thoughts regarding God ran something like this: "I will have faith. Who am I not to have faith? But I sure don't know what you're doing up there."

My first "verse of the week" is where Paul describes the holy spirit interceding for us when we can't find the words to pray with.

The spirit must have interceded, because during a particularly difficult time, my brother said to my great surprise: "Sida, can we pray together?" It's surprising because he hasn't really been exposed to much Christian upbringing at home. But we took a walk to be away from the shouting and prayed together, taking turns. It was wonderful. When we got back, we came home to relative peace, although of course the air was still thick and tense.

Today at youth group, after all the activities was finished, a guy decided to show me a verse of the bible for no apparent reason. Isaiah 30:18. I didn't pay a great deal of attention because it was time to practice our choir, and also his bible was of the version where there is a great deal of explanatory text and stuff in square brackets, such that the idea was scattered. But I did remember it so I could look it up when I got home.

"Yet the Lord longs to be gracious to you/ he rises to show you compassion./ For the Lord is a God of justice./ Blessed are all who wait for him!"

The message is clear, and I will wait for Him. But it's not easy, to have faith and be patient while everything crashes around you. But seeing His words does make me feel better, even though there is nothing new that I didn't know already.

My recount ends here. Don't worry, I'm not crazy, you can sleep soundly tonight. And I won't do anything silly. I'm to damned cowardly (or too sensible, depends on how you call it) for that. Besides, I have my God. I feel silly to have written this much, I have never exposed my sores so publicly before. But no matter how people judge me having read this, or even if no one reads it, I feel better for writing it all down.