ear nose throat

ear nose throat. funny how things are inter-related. how one thing can lead to another. even our organs are created this way. anyway, i am loving this posting, coz at least its not as tiring as accident and emergency.

acls is over and i can proudly say that i have passed :D but whether or not i can react fast enough and recall the algorithm when someone collapse in front of me is another issue.

have been trying to get back on track these few weeks. i duno if this is the kind of life i want, but at least i feel more at peace with myself.

3 more weeks and semester 8 is over. then i am leaving to taiwan for my elective. i cant wait to leave this place coz it kept reminding me of someone.

need to exercise and control my diet from now. then i can eat till i die in taiwan! ;p


if anybody say this to me, i will melt like a chocolate!not exactly anybody, maybe only somebody. but i don't think i will get that. cant believe i am saying this, but i actually miss all the sweet talkings, and how you made my heart skip a beat :(

sometimes, i really don't understand you.

200th post

wow. this is my 200th post. i am amazed myself. this blog witnessed my process of growing up. i hope these posts here will be gentle reminder for myself not to repeat mistakes which i have done due to my naiveness.

being in accident and emergency department for one week has taught me a lot. red zone can either be a havoc like a disaster scene or as quiet as library. during the havoc period, thats when us as medical students get to kaypoh a bit and try to learn.

and during these havoc moments, thats when i realised i just cant think straight when i am nervous. thus a lesson to learn, i have to remain calm, controlled, confident, focused and observant, even when the world is in a storm. Have you heard of in the midst of the stormy disaster, the most tranquil place to be is in the eye of the hurricane? i want to be there in the midst of a storm.

and the only way to do so is by experience , experience, and experience. only through experiences we will gain confidence. i remembered how my hand trembled when i first attempted to insert an intravenous line. now, i can confidently put in one :)

being in the field which death is such a common matter made me feel desensitised. somehow, i feel cold. feel apathy towards patient's pain. i do not want to be this way. but the more i have seen, the colder i have became. and this is worrying.

i love the on calls at night in A&E. because it keeps me occupied. instead of sitting infront of my books passively trying to absorb the never ending medical knowledge, the running up and down in A&E is as good as jogging/swimming. and at the end of the day, i will feel so tired that i collapsed in the bed after getting home. spare my mind from thinking about nonsense.

i just cant wait to leave here. to be away from all this. 5 more weeks!

reasons to smile

got a package from my dear postwoman, wy, all the way from philly :) it really warm my heart. reading through the postcards made me feel loved, this familiar feelings which i have long forgotten. hamsap, you just never failed to make me smile ( and tear) :)

and in the postcard, there's one line which i once wrote, which i have forgotten,

'you know, your ventricles need to pump very hard to circulate blood through your body. For every pulse, every breath, there are so many things happening in your body. so, don't waste your heart beat'

well said. i know have been wasting my heartbeat.and i know there's a sequelae everytime i get hurt. i know i have made people who care about me worried.

weekend break back in kuantan made me realised how much i have made my mom worried. she said i look cachexic. i have lost the radiant on my face.i have lost the smiles. and her heart aches when she sees me like this. i need to take that fresh new step forward, and not allowing myself to fall deeper.



anyway, thankyou hamsap!for everything!for being the very special person :)

hope

just as the name of the blog, hope keeps me going. things can only get better :)

answer

sometimes, we ask for answers. often, we don't get the answers. we spent our time thinking and thinking.

perhaps, what we need is not an answer. its a decision.

and to make the decision, it takes a lot of courage.

downhill

how can all these happen so fast? i hope things could end up better.

this is like a vicious cycle. everything is so familiar. i went through the whole cycle before.

why do i always allow myself to fall into the same maze?

i always hope if there is someone who can tell me what i should do at such moment. but i know certain things you just gotta learn to solve it yourself. coz thats how you learn.

but i never seem to learn from mistakes. and i am going downhill again. i hope i can go back to the pre-eos period, when i just study study and study, nothing else but study. at least i feel like a human then. a useful one.

i cant wait to go taiwan/sg. away from all this. coz everything in my room reminds me of somebody. and its just plain torture.

looking back at my blog, i think i only update whenever i feel sad. many things happened in between. many reasons to smile. maybe what dr P said is true, we should always look at the positive sides of things.

strength

i think pre-exam period is the time that i reflect a lot. what to do, i am easily distracted. anyway, reflection of the day, my friends say that i am a stressor to people around, as in, i tend to make people feel pressurized. i think i portray myself as someone who is very strong, especially for people who do not know me well. not many have seen me teared. thankfully.

personally, i do not think that i am very strong. i break down very easily too. its just maybe i am not comfortable to do that infront of other people.

but i think my immune system is breaking down nowadays. the wall is slowly crumbling. or am i too tired inside this wall? the wall which i have built to protect myself all this while.

maybe i need the adrenaline rush, the stress, to push me harder. push me away from thinking so much.

wedding invitation!

wedding cupcake :))

nope nope. i am not getting married yet. lol. i wished. instead, i got my very first wedding invitation yesterday!

ahhh. wedding is such a happy thing. and i am so happy for her:) and , she is the top top student in our batch. i admire her for her discipline, how she can focus so well. i wish her happiness and much love!

first invitation. and i foresee many many more coming soon! maybe i can be like the show 27 dresses. lol. i like to go online and browse through those wedding photographer websites. it has became a habit to destress. every couple wants their wedding to be immotalized. and those wedding photographers are just so awesome. they are just so good in capturing those special moments:)

:)

so, the war is over. and i am proud to say that i have fought it well :))

having more than one lecturer saying that you are just not good enough is really a good form of motivation. it feels great to prove to other people, and most importantly to yourself ,that you can actually achieve more than you can ever imagined.

it still feels like a dream. i am really grateful that my effort is paid off. the sweat, tears, every small step, throughout this year, are not wasted. the satisfaction after trying your best and getting what you desired is awesome.

i will take this as a motivation, to motivate myself to work even harder. i know with effort, with faith, with your 100% heart, you can achieve what you want:)

i owe my gratitude to so many people. but most importantly my parents. i know i have made them worried. i need to learn to be independent.

thankyou so much. to you . you. you. and yes, you who is reading this now :)

war

the EOS war will begin soon.

i hope by then i will be all prepared.

everyday, i just want to tell you, it is not because of convenience, now.

but it was because of inconvenience, 3 years ago.

anyway, i shall be focused to fight this upcoming war.

smile and jiayou :)

still breathing

i am still surviving, despite the crazy timetable. there goes three weeks of obs. and in few weeks time will be eos. everyday is a new learning day. the more i learn, the more i realise i duno something. its tiring, every night coming home to collapse on my bed, but it feels good to coz i know i have fully utilized each day.

i presented a case on anemia in pregnancy the other day. during physical examination, i commented that there is no pallor in the patient even though her hemoglobin level is just 7.5g/dl. the lecturer took a look at her palm and compared with his, and said, how can u say there is no pallor? coz obviously his hands look much more erythematous compared to the patient's. But i took up my palm and compare, mine is paller than the patient. lol.. the lecturer was then speechless. lol. i also didnt believe that she has no pallor on the conjuctivae and palms until i compared with mine. maybe my Hb is lower than a pregnant mother with twin pregnancy. lol..

looking at so many pregnant mothers with medical / obstetric problems in the ward everyday, i am thankful that i didnt create so much problems to my mother. and i am thankful that i was born healthy and not sent to NICU after delivery. i am thankful for my mother, for her unconditional love which has guided me all these years :)

hope the new year has been good for everybody.

happy new year:)

spent my new year eve typing case summary for obs. and the comment from lecturer was :)) it feels great when your effort is paid off. but i believe there is always room for improvement. will try to do better next week/year ;p

last day of the year, listening to the new year speech by our dear prime minister, i dont feel lonely at all, even though i have all by myself today.

it has been a great year, many ups and downs, but i know they are all there so that i could be a better person. i know i always complain. but i thank god for whatever that happened.

2010 brought many great experiences. i believe 2011 will promise more.

quoting from a book, ' when you are in hell, find a bus stop and sit down. we wait for the bus, we know its coming, but we don't know when. whether its stormy or sunny day, whether you are in hurry or not, you still gotta wait. it comes when it comes'

i just have to constantly remind myself that bad days will pass, so will good days.

anyway, happy new year! may 2011 bring us happiness, health and much love :)

busy bee

busy beee. obs has been really crazy. with average of 4-5 hours of sleep everyday, everyone is like zombie. labour room was great. but i told myself i will never have normal spontaneous vaginal delivery after assisting a few. i feel the pain for the mother in labour. with every contraction, the mothers cry in pain. but i also shared the joy of every mother as the baby's head pops out. as the baby cry, everyone smiles :)

one thing about obstetrics, whatever that happened during the pregnancy or labour, the baby will be born alive most of the time. so it will most likely be a happy ending :) but the workload is crazy. student rounds every morning infront of houseman and mo are just nerve wrecking.

i am thankful for the weekend christmas break, eventhough its just 2 days. felt much charged and much loved :) today is the first day i finally get to sit infront of my comp and slack slightly.

a month more to EOS. i duno how am i going to go through it. but i know it will be over in no time. gotta add oil!

side note, i spoke to a senior after so long. still as inspiring as ever. one thing which he mentioned stuck me, he said our character should always improve and develop. so true. but so hard. he reminded me that there's a life beside being a medical student. other roles which we have in life. a point which i almost forgot.

christmas

christmas is in a week's time. not that i celebrate this over commercialised day, its just everybody else celebrates it.

bought a non medical book today, after so long. realised that i need something else in my life besides medicine. which is quite hard, because i don't even have enough time for medicine. Learning from the Heart, by Daniel Gottlieb, the same author as Letters to Sam, a book which inspired me so much. gonna read it before obstetrics start, before the war begins.

just got over paeds. cant say i love it, but its not as bad as what i have imagined. kids can be really annoying when they are ill, just like adult, lol.. but they are really cute when they are well. its funny to see the way they talk, they way they think. reminds me a lot of my niece:) exam was okay, wasted all my adrenaline panicking the night before. but i am glad that it is over.

i have been a good girl this year. will santa send me what i want? i duwan anything much.

all i want for christmas is you.

merry christmas :)

bye mr black :(

it was a tragic week. my stethoscope took its last breath. huhu. while following the ward round, the doctor was commenting that particular patient has THE classic sign of a disease, so i went there and auscultate the patient. and i heard nothing. after trying on my friends many many times, i finally gave up and certify its death :( cause of death: idiopathic/trauma/infection. heh.

my first stethoscope, accompanied me for 3 years+. from the noob that didnt even know which side to put in, to being able to recognize murmur in patients, it has served me well.

and thankfully, my gp told me that he has one brand new extra stethoscope! and he gave that to me :D that saves me pocket from a hole. sometimes, you just gotta be thankful with what u have.and i am.

my old black stethoscope, and meet the new Mr grey :)

its december already. time really flies. means exam is one step closer as well. research is on the run too. cracked my head trying to key in the data. paeds is ending soon too. so fast so fast so fast. and my immune system is failing me too. i have been getting sick every posting since psy, ortho, and now paeds. at the rate that i am falling sick, i will acquire all the antibodies and antiviral by the time i graduate wei! ;p

care

so true. i feel, we always tend to hurt the people who care for us.

i need more strength

got back ortho and psy results ytd. i got my first A in clinical school, and also first failure in my medical school.zzz. still can't believe i failed the ortho paper. and still can't believe i got A for the ortho clinical exam. irony. anyway, i am thankful that i didn't fail both the paper and clinical, considering i have such a horrible posting with so much distractions.

went back to the ward on a friday nite. paeds ward was quiet. so we got a chance to speak to the houseman who is oncalling. when asked how's the life of a houseman, she said, the worst day as a medical student is nothing comparable to a day as a houseman.

responsibilities, scoldings, are what you get everyday. you will feel stupid everyday. you will wonder what you actually learn in the 5 years of medical school. you try very hard everyday, but its never enough. thats what she said.

i remember i saw a specialist scolding a houseman, and infront of everyone, her tears rolled down. at that moment, i told myself, i should never never be like that. i must train my crying tolerance level so that i won't cry so easily.

and despite the increasing number of houseman, the workload is still a lot. just yesterday, a houseman was involved in accident after oncalling because it was just so tiring.


huhu. i am scared. i am not sure if i have the mental ( and physical) strength to go through all this.

but at the end of the conversation, she told us, whatever happened, just tell yourselves, never never give up.

yes, i have to keep telling myself, never never give up!

man vs machine

today, during our class, we were discussing murmurs found in child, which most likely due to congenital heart disease. the lecturer asked what should we know as a medical student/future doctor? to know there IS a murmur, or to recognise what is it? his answer was, we are only required to know if there there IS a murmur, coz everything after that will be answered by a machine called echocardiogram.

last time, when there wasn't echo, doctors are expected to come out with diagnosis and management just by using stethoscope. things has changed huh? i wonder will it be a day that clinical skills are no longer important anymore, and everything is replaced by robotic machine, they can make the diagnosis, they can manage the patient.

what is different of us and machine is that we have clinical skills to recognise different signs, which a machine could not do, the rest can be done by a machine. anyone can just google their symptoms online and get the management plan easily. but, with more and more medical schools mushrooming here in msia, i wonder if we will get enough training for our clinical skills. if we are competent next time. if we can do better than what a machine does.

but i do hope i can work like a machine now. recharge by plugging in and can work once fully charged. i am so tired already. zzz. 10 weeks to EOS. ohman! howtostudy7postingsalltogether.to handle the current posting is tough already, to revise the past postings are insane.

machines are good because they have no feelings. they are not emotionally attached to anyone.

but when they could not take it, they break down.

i really really hope things can end up in different way :(

its the kids!

yep, i am now in paeds! bye bye to bones, and here come the kids. first day in the paeds ward just made me miss my niece more. i am going to head down and meet her this weekend :)

just finished ortho and psy exam last week, rushed back to kuantan, not to rest, but to rush my 5case summaries. i remember seniors telling me during my phase1, semester5 is like walking in the park, and clinical sch is like running up mount k. to walk up to mount k is tough enough, i couldn't imagine running up. but i undstn how it feels now. i barely have time to breath before the new posting starts. and i foresee things will just keep coming and coming till feb next year.

ahhhhhhhhhhhhhhhhhhhhhhhhhhhh. i want to go up to a mountain and scream my heart out. but i don't even have any energy left to climb up. ahhhhhhhhhhhhhhhhhhhhhhh.

i feel like going home again, eventhough i just went home over the weekend. i miss my parents. and the warmth at home. and most importantly, i dread coming back to my room, driving my car, passing by seremban town, coz it reminds me of somebody. blah.

i thought things could be better. but i was wrong :(

晴天雨天

下了好多场雨， 几时是天晴呢？