things to share

Am reading this book called God never blinks by Regina Brett, it's about 50 lessons for life.

Been feeling inadequate these days, until I read this line in the book,

''the last time I climbed out of the 'I am not enough hole', I prayed, 'how will I ever believe that I am good enough?' The answer came in that small still voice from my heart:' By helping others believe that they are good enough.''

'' Don't try to fill anyone else's shoes. The world doesn't need you to be Mother Teresa, Gandhi, Martin Luther King, Michael Jordan, Maya Angelou or Bill Gates. The world needs you to be you.''

away from home

it's been 3 good months away from home. Finally I have time to sit down, after all the crazy interviews ( I do hope more will come). It's good to be home here in Tucson. Not exactly my home -home as in Malaysia, but I feel good to be back.

Interviewers asked, do you have family here in US? I answered no, but I should have said, I do not have family here, but I do have friends who treat me like family members.

Going to interviews made me miss home even more. Questions like what are your long term plans? What made you want to come to the states? Tell me more about Malaysia.

And so I was reminded of my purpose. My goals.

It's a mixed bags of feelings. Something which is hard to explain. I am sure any Malaysian expatriate will understand this.

The grass is always greener on the other sides. Things are definitely much better here. But certain things, like comfort and the familiar feelings are something which can't be found here.

I remember sharing my experience in Singapore in one of the interviews. Going to Singapore was an eye opening experience. I was from a small town, Kuantan, I am confined to the small city, not knowing how big the world outside can offer me.

Yes, it changed my life. The two years in Singapore. Looking at how this small dot can progress, it is definitely a big slap on the face. We have so much more potential, in terms of resources and talent. But it is just wasted away.

Stepping out of my comfort zone. That's a big step I made. It's not easy. Nothing is ever easy.  Saw this quote: the number one reason why people give up so fast is because they tend to look at how far they still have to go, instead of how far they have gotten.

I have gone this far. Further than I thought I could. I always welcome surprises. Also opportunities. They said, opportunities are for people who are prepared. I agree!

From one side of the world

Been in the states for 2 months. To many, this is like a dream. To me, it is like a dream coming true. My close friend said, she is glad to see I am achieving my goals one by one. I am thankful and grateful for whatever I have been through this 2 months. It's a life changing one.

It didn't feel like 2 months. I remember stepping out of the airport at Tucson airport, greeted by gigantic cacti and the dry hot weather. Followed by going to my mentor's house. He is really one great man, without him, I wouldn't be where I am now. First question he asked me was what is your goal here. Of course, after 35 hours of flight, I was very slow in my response. However, he laid out what I should focus and be clear with my goals here in the states. That was my very first impression of him - focused and intense.

Then, I met many many many other people whom I owe a lot during my stay. These people have have helped me in one way or another, making me feel very at home. I admit, there are times which I miss home a lot, miss the comfort of home, miss the convenience of things, things which I have taken for granted. Comfort zone, yes, the circle which I missed. But I always believe we need to step out of comfort zone in order to succeed. Staying comfortable in one's circle is not going to bring us far.

Travelling to the big city in the states made me realise the world which I was in was so small. Felt like a really small fish in a big pond. Had the opportunity to join the world largest interventional cardiology conference in SF. It was amazing. I am truly inspired by how all these great people coming from different parts of the world, gather in one place, and how they passionately describe on their discoveries, sharing the new skills. I hope there is one day, this small fish can contribute whatever she gained here in the big pond back to her original pond, hopefully play a part in expanding the pond.

Preparing for interviews made me sit down and reflect. Simple questions like ' Tell me about yourself, why do you want to do internal medicine, why United states, etc ' are things which I never really took time to question myself. And I am very happy after my first interview when both the interviewers commented that I have really good exam scores. It felt like all my hard work paid off. I can imagine the day when the match results are out. I hope things will go smoothly.

My goal was to secure a residency here in the states. But I can proudly say that I have learnt more than that. There is definitely more in life than that. I am blessed to be given this opportunity to see what I have seen, to hear what I listen, to have chosen this path. I am hoping can my loved ones can share this blessings which I have. I hope the next time I update I will have more good news to share.

The end of something and the start of something

8th August marks the last day of my service in the ministry of health. Submitting my resignation letter a month ago felt just like a day ago. Time really really flies.

It's a great feeling. To see how you yourself have grown so much. I am so amazed to see how much I have grown through these hardship. They say, housemanship is tough. They say, housemanship is torturing.  I say, housemanship has made me a better person, a better doctor.

Reading some of the experiences of my friends who are doing housemanship in other hospitals, I am grateful that I am sent to where I am now to do my housemanship.

Bidding farewell has never been easy. Leaving this place where I spent almost 15hours/ day 7 days/week for the past few months is not easy. I am glad for the friendship I have made in this few months. I am glad for the experience I had.

Last day of work, with lots of unforgettable experience. The most malignant specialist, who shouts at everybody and everything, who is so anal about things, narrate even 'bracket', 'arrow'. He is one of its kind. Issued 'DNR-do not resuscitate' to two families. I can't spell how difficult it is to do it, eventhough I have done it so many times. Followed by assisting a pleural tapping. This patient, I have managed her during her last admission, until her discharge. with underlying advanced stage IV lung Ca, she is definitely holding it up very well. very optimistic lady. never complain a single word when we attempt so many times to insert long CVP line for her. Now she is readmitted, on the first day of Raya, looking very ill. The smile which she used to have, is masked by the pain of the disease. I hope she will continue to hold on. My last day was highlighted by a patient who was trying to abscond away from the ward and created a big drama. lol.

I hope I never regret this choice which I have made. Quitting my job and chasing after my dream. Leaving this place in a week time. I know this journey will definitely make a different person. I just hope this change will make me a better person. I look forward to it.

Real doctoring

It's been long since I updated my blog.

So much to share.

It's been 4 good months. I completed all my steps, got my ecfmg certified :)

Started working in the very hospital which I was born. One thing for sure, I have learnt a lot not only from my seniors, I have also learnt a lot from my patients. Recalling back, I could not even put in a intravenous line properly without trembling. The palpitations when I had before my first night shift. I am very amazed with how I have progressed.

They said, you have to be grateful for what you have. I have to say, I must be the luckiest person on earth. I have very good superiors who have guided me along the way.

Tiring yes, but everyday, I look forward to go to work. Everyday is a new day for me to learn. The more I learn, the more I realise I am so inadequate.

I dealt with life and death everyday. Seeing patient gasping their last breath is not a good feeling. Pronouncing death was not pleasant. The straight line which we used to see on TV is something I hate to see on the cardiac monitoring after an hour long of resuscitation. But it is unavoidable. It also makes me realise, the difference between being alive and dead is just the breath that you are taking.

I am very honoured, to be able to be so close to someone's life. I will never forget the moment when there was once, relatives of a patient came over to me and shake my hand and thank me after I finished my night shift. I was taking care of this patient for few weeks. His condition was deteriorating so fast that we actually have no idea what disease he was having. At one point, his relatives were giving up, they just want to know the answer. We did dozens of test/scans, still, there was no conclusion. And on that very morning after I pass over my job to my colleague and was about to go home, the patient took his last breath. I didn't know that until the family members came over and thank me. Only then I found out from my colleague that the patient passed away. Still, there was no answer to what he was having. I feel really sad and dissappointed. We were too late. But I could see the patient's family members were really thankful of me.

Being a doctor has been my childhood dream. I dream of wearing the white labcoat, with the pretty stethoscope around my neck, and being called, Doctor. Now, I am a doctor. It wasn't like how I dream. But I am truly happy to be one. And I would say, I have never regretted the days which I spent crying due to the stress in medical school. Because, now I know, there's a reason for the pain. It is to lessen the pain of my patients. There are times when despite trying our best, we still lose the patient, but I have learnt to accept. We can only do our best, after all, it is still up to god.

I am going to leave this place soon. 18 more days. Hopefully I won't regret my decision. May we all excel in whatever do.

t minus 11

t minus 11 to the exam. been running low on motivation. came across this video which is really inspiring. Actually watched this during my ck preparation, but this time it makes more sense.

Whoever who are on the same boat as me, may all of us succeed in this exam. It's definitely not easy. but we really can't let this exam define who we are. definitely should never let this exam stop us from achieving what we want.

It's that close. really close. I have to give my final push.

I just want to pray that I can have a good sleep and rest during this final phase of preparation. Please grant me the peace, confidence, strength to pull through this.

Doctor-ing

Recently, I saw one piece of news circulated among my FB friends. It's regarding the letter from ministry of health stating that more than 95% of the post for medical officer in the country have been filled, and in certain states, it has even over-filled.

This is an irony. One side of the story, so many government doctors are complaining that they are over-working, another side of, the government is giving letter stating that the post is going to be over filled.

Question is, what happen after that? So, very soon, as predicted by many, doctors may be jobless.

The 5 years journey of medical school is definitely not an easy. and when one is faced with such situation after graduating, who is going to be responsible?

During the family gathering last month, I was asked, how do you sum up your medical school life? Did you cry everyday? Lol, to be honest, I did cry, from stress, from relationship issues, from family issues etc. Of course, I still cannot forget how traumatised I was when I witness the first resuscitation in the ward when I was still a pre-clinical student. I can just hear the bone cracking underneath when the doctors are doing the chest compression.

So, ask me again, is it worth it? The answer would be Yes. Regret, definitely, especially at times when I just cannot cope with the stress, when things can be so easy when you just say, I give up.

But, I hold on to it. and the happiness when I received the scroll with the piece of paper stating MBBS is just..plain bliss.

That was a dream since childhood. And yes, it has came true.

They say, 'the dream is great, but who you need to become to get your dream done is the real reward. '

I am truly blessed, to have met the people in my life, for without them, I could not have achieve what I have today. I think the long path, or what people name it as 'calling' has definitely changed me in a way.

5 weeks

5 more weeks to the big war, my final war to go!

Been doing UW Question bank last week. It is actually considered by most exam takers as one of the best tool for preparation in usmle. I am left with 1325 Q to go. Doing 3blocks of questions a day, slowly, and surely I am reaching the finishing line.

The journey is not easy. Of course nothing worth having is going to be easy. Something and for some reason, I am led to this path. Whatever reason it is for, I am going to do my best. I have learnt so much during this journey, not only medically, but also many other aspects. I am sure this will make me a better person at the end of the journey.

After this, I am going to use all this knowledge that I have to help ( hopefully and finally). One of my lecturers in internal medicine actually told me, we have been receiving much, so it's time to give out some. I totally agree with this. I am going to use whatever I have ( regardless how little), to give back to the people.

So much has happened since I last posted. A close family member of mine has pass on to a better place. They say human come and go, without notifying you. Death, just like labour, can happen anytime, and caught you in a surprise, either in a pleasant or a not so pleasant way. ah gong, wherever you are now, I just want to thank you, for without you, I would not be typing this here. may you rest in peace.

Another piece of news, ( good news at least) , I have passed my step2 CS. Compared to the forum mates which I have practised with, I definitely do not deserve this. But I really thank god this this. After ck and cs, I am left with the very last giant step to go.

Just have to tell myself, keep going. Just have to repeat this" I am not telling you it is going to be easy, I am telling you it's going to be worth it.

brain

Brain is such a amazing organ. one which differentiates us human from animals. it's function, of course can be good or evil. there's always an angel who is talking to us and at the same time there will be one devil opposing it.

Many think that angel is the good one and devil will always be in the dark side. This applies to most cases, but in certain situation, the devil will act to protect us from whatever out there which is detrimental to us. It actually serves as a protective mechanism.

Of course, this triggered me to think, whenever I am studying, I felt tired. So is it tiredness, which the brain is telling me to stop and don't overwork OR is it just the devil side - I am just plain lazy. no idea.

But I can only conclude, self mastery is very important. It's all in your mind.

# side note after watching a very motivating movie: Gifted hands: Dr Ben Carson. Dr Carson the youngest appointed director of paediatric neurosurgeon in john hopkins university hospital was an amazing figure. You should google it to find how impressive his life story is and should totally watch the movie if you have time.

anyways, in one of his sharing, he pointed out how complex our brain is, how many billions neurons are working in our brain. He asked the crowd, how many of you remember your birthday? for this simple action of raising your hand, do you know complicated it is?

to spell out the mechanism in minutes is tough for me, but for the brain to process the question that we hear passing from our external auditory canal to inner then convert it to chemical energy passing it to our auditory cortex which connects to our motor centre to allow us to raise our hand, it only takes seconds for us to raise up our hand to answer to this stimulus. Awesome right?

and even more awesome is that all these are happening without us realising it. We never even thought about all this thing and our brain are diligently processing it in such amazing manner. Our brain can achieve soooo much without us realising.

so, imagine, what can WE achieve, if we put something that we want to do in our brain, if we are consciously thinking of doing it?

He also mentioned, he operated on many many many brains. And upon opening the skull, underneath the dura is our brain. And all human brains are the same, regardless you are black, white, female, male rich or poor. So, all this are just a cover. What differentiates one to another essentially is how you make use of your brain.

One question that his mother always ask him: do you have brain? if the answer is yes, stop making excuses to the problems and start finding solution. Because what is needed is all up there in our brain. We are equipped with everything we need to solve a problem.

yes, it's all in your mind!

concentration

It's 86 days to my exam. I am planning to schedule it on the 4th April. Here's the link to my prep journal again.

http://www.prep4usmle.com/forum/thread/115662/

CS was a very humbling journey as I got to know many people from all over the world. Some are phd holder, some even got offered a teaching job in my university. But they are all on the same boat as me, fighting to pass this exam.

As I started my preparation for step 1, I realised I am in a very different boat as step 2 ck or cs. After all, it's the first step in the long usmle journey. It is also supposedly the toughest exam. The people whom I met in the forum is definitely different from those in step 2. Many have given up half way or if they fail or scored a below average results. of course, there are people who took the exam for the second or even third time to fight this step 1 giant. The very difference is the determination. How determined you want to pass and do well in this exam.

Been unable to ceoncentrate well this few days. Today I realised, the only thing which can make me feel good is the feeling of accomplishment. And this good feeling is the main push for me to study harder. Of course, the determination.

Had a long discussion with mom yesterday about this issue of determination. How determined and how confident am I to be able to continue my training in the states. For now, honestly I don't know. I can only say I am taking one step at a time and my plan now is to give my best for step 1. But one thing for sure, I want to go higher in this ladder of medicine. I don't want to just be another-doctor-in-the-neighbourhood. I always believe we have to give our best in whatever we do,hopefully we can be at the top the ladder.

May we have the strength and determination to pull through whatever the future holds.

Gratitude

Just saw this quote somewhere

'Gratitude is proportional to happiness.'

 So true.

I have to be more grateful for what I have than what other people have.

Happy New Year

Happy new year!

I am back from the states. It's been a good month, travelling here there, moving from one place to another. Honestly, it was rather tiring. But who am I to complain, it was a fulfilling trip. Going to share what I have learnt from the trip:

1) travelling does open one's horizon- the experience of travelling, especially if you do it back-packing way, cannot be learnt from any book, any documentary on earth. All this thing, you need to experience it yourself. The feeling of being thrown in an unknown place, exploring the place and the culture of the people, is the most valuable thing which I have earned. I always believe that in order to understand a place, one have to stay there long enough, knowing a place cannot be done by just joining a tour, hoping from one tourist spot to another. so, before I have osteoarthritis, I am going to do back-packing style of travelling!

2) we are soooo far back - Being in the states for 3 weeks and also in China for about 12 days, this does make me realise that we are so far back. I am not comparing only to the states, even when I am comparing to China, which was once so underdeveloped, it has now gone far beyond what we have achieved. Take for example public transport, Shang Hai has like one of the fastest train in the world, which runs at a speed of approximately 400km/hr. Amazing right? even the subway system itself is much more developed and organised than us. I once read somewhere, how developed a country is not judged by how big the cars owned by the citizens, it is determined by how developed is the public transport system. We definitely have a lot more to learn.

3) home is still the best - I think I came to that conclusion after I came back from taiwan and singapore one year ago, but I am going to repeat this. Regardless how advanced or how developed other countries are, nothing beats home.
Firstly, the weather. I was so happy when I was embraced by a temperature of double digit when I step out of the airport. you cannot imagine how hard it is to live in a country which is so cold and dry. I had like nose bleed almost everyday due to the dry air. It was sooo troublesome having to check the forecast before going out each day so that we are not under/overdressed. I feel so much lighter back home here not having to wrap myself up with 5 layers!

Secondly, I realise regardless how fluent we are in mandarin or english, there is still a difference when we speak to the caucasian or to the local chinese people. it's not easy to learn the accent, perhaps it takes time. more over, there would definitely be cultural difference. we may understand every single word they say, but we may not be able to catch the meaning due to a cultural difference, vice versa.

Thirdly, you would not imagine how hard it is for me to find a plate of veggie to eat in the states. unlike back home, I normally have like 2 dishes of veggie each meal. there in the states, even to buy a fresh veggie, they only have salad in the normal caucasian supermarket. So, if we are desperate for REAL veggie, we need to go to some korean mart to get them. Of course, that explains the constipation which I got! lol.


and the list will go on and on.

People may ask, if I love back home so much, why I am still pursuing my goal to get to the states for residency training? The trip to the states has definitely make me more determined of my goal - for the reason mentioned above- no 2. we are so far back. Can't use a ruler to gauge how far back we are in medicine, but when I compare myself to my peers who went there to study, I am definitely no where compared to them as far as what I have achieved. It was a humbling experience, to see what other people of my age has already achieved. Perhaps, it's the america culture that pushes people to strive further.

So, to make my resolution of the year:  I am going to stretch my limits, to achieve a greater height in terms of my career, personal attributes and also relationships.

side note, I am starting my step 1 preparation today. ( completed step 2 ck and cs and I am glad that step 2 ck turned out alright! hopefully this will be a motivation for me to perform better in step 1)

2012 has witnessed lots of magical moments, hopefully year 2013 will promise more! Have a blessed year everybody!