yesterday has to be hands down my most embarrassing 'unglam' moment of the year, no, make that of my life.
i brought my dog out for a walk as i always do, but for some reason, i decided to change our usual route. so i walked up 6th avenue, turned left and ventured into queen astrid park...which ive never been before but anyhow, decided to be adventurous and just whack.
but heres where my severe lack of sense of direction comes into play. i think i got distracted at all the gorgeous houses with their awe-inspiring swimming pools, that i forgot which way i was going. and so there i was stuck in the middle of nowhere, but to make matters even worse, it started to pour. not the nice drizzly sort where you can appreciate the smell of the rain. no this was the torrential thunderstorm type, with the full fledged thunder and lightning and in just seconds, nike and I were completely soaked to the bone.
plus by this time, i think nike was getting really tired with all the walking (he hasnt walked since ive been gone) and being the prissy prima donna that he is, he hates getting wet (as in hate with a capital H) so my prissy prima donna refused to continue walking and just wanted to lie down in the middle of the road. i literally had to drag him along because i refuse to just sit there and wait for the rain to stop (luckily i didnt since it took 3 hours to stop)
so in desperation, i called my daddy, who looked up the online map and guided me out of the maze PHEW. thank goodness for the internet and handphone.
heh so i suspect we must have made quite a sight, all the passerbys (with their HUGE umbrellas and never offer to share. bah singaporeans) must be thinking whos that crazy girl walking in the rain and still dragging her poor dog along with her. i only hope no one i know saw me that day.;P
today me and my sister took the mrt during the lunch hour peak rush, and it was a rather interesting experience. it was interesting because i realised all that courtesy campaign was in vain. no one waited for people to alight from the train before pushing to go in. and so that created such a huge jam. and i really hate how mrt commuters have no peripheral vision (bitemporal hemianopia?? :P) i mean, they just enter straight into the train, and hence clog up the entrance way, leaving the sides of the train super empty, so there was alot of standing space in front of the seats but yet no one else can enter the train because the entrance was already blocked by these selfish people.
and another thing that irritated me was that due to the heavy rain outside, lots of people were carrying umbrellas...BUT it never dawned on them to tie their umbrellas up or put it in some sorta bag. so they leave it dripping wet with water EVERYWHERE, and didnt even care if it dirtied other people's (ie. ME) shoes. bah.
but its nice to be back, and hearing all the singlish which really amuses me. Plus seeing my dogs and parents and im meeting up with the friends soon after their exams and starting our mini tour :) that promises to be very exciting! i think first up is pulau ubin which ive been going on and on about and would hopefully finally get to go this coming sunday haha
last day of the exams, which is sucky because my paper is at 245 pm and me being an early bird, awoke at 630 am and just cant back to sleep. so now im stuck with this extended period of waiting. i hate the wait...too much adrenaline
anyway my written paper yesterday was how shall we say. INTERESTING. interesting because i hate how they write 2 lines, 'patient has fever, shortness of breath for 3 weeks, what is the most appropriate diagnosis' im like HELLO! im not dr house you know, can you please supply more information, like how high is the fever, what kind of dyspnoea are you talking about, just SOBOE(shortness of breath on exertion) or orthopnoea (on lying down) or PND (shortness of breath at night)? are there any other symptoms like chest pain, sputum etc. bah and my eyes popped out with the 2 words. GRAND MAL. (it used to refer to generalized seizure) but omg who ever wrote that question havent opened his/her neurology text in THIRTY years!! yeah its been so out of date and fashion for the last at least 30 years, no one even uses the term anymore. in fact if you use that term in front of a neurologist, be very prepared to get lambasted. i think if you want to set a neurology question, either 1. be a neurologist yourself or 2. check the CURRENT texts..i mean medicine is an evolving field you just have to keep up. in fact this applies to every field not just neurology, so theres really no excuse.
and there was ALOT of antibiotics and STDs (sexually transmitted diseases) which isnt fair because we havent learnt STD. and i know the azoles can be used to treat candida (thrush) but if you give me a choice of metronidazole and fluconazole., you are seriously testing the limits of my antibiotic knowledge.
but the paper did have its merits. there was more than 20% neurology i reckon :) so that was good, and pathology questions were very well thought out and were the only ones that were properly constructed. it is such a pleasure doing questions that the tutor has OBVIOUSLY put some thought into, giving you all the information needed.
so now on to the OSCE. i feel rather prepared. rather because its an on-the-spot testing. basically you have 2 minutes to read what you have to do, calm yourself, and when the bell rings, enter the room and the adventure begins. and this happens 12 times. its almost interesting, (aussies will know about the show 'thank god you are here') i quite enjoy the adrenaline, in fact its almost fun, but like i said because its so unscripted, and you havent got the 3 hours to think through your answers so that gives it the edge hehe, so fingers crossed!
and so 3rd year ends. quite without fanfare, since everyone has absconded from clinics and ward rounds, holing up in their homes or the library studying away. but we did have a nice lunch with the group and our tutor (pics later)
i always like the beginning and the end of the year. the beginning because everything's different, its like a fresh clean slate again, and the end, because you get to reflect on whats happened, whats changed.
so heres my reflections on my 3rd year of medical school.
i think med school changes us alot. Most of the people who get into med have gotten there through hard work and a few bright sparks. the thing is for most of us, studies up until now have been well under control, we were usually the A students (not that people who are in other courses are any worse at academics), so that made us really confident (or cocky) in our abilities. we knew that if we finished the TYS (i still remember this!) or whatever assessment book, then we'd do well.
THEN comes med school. suddenly, everything is no longer as it was. first theres the information overload, anatomy physiology biochemistry, pathology, pharmacology, microbiology, etc. and me, whos never done bio in her entire life and up till 2 years ago wasnt even sure whats a DNA (thankfully i do now, really). trust me its not been an easy time in my life haha. then theres the reality that no matter how hard you work, it just doesnt seem to be ever enough. And thats when it all starts to unravel and you lose control, because you start to feel demoralised about the effort you are slogging through. and getting those distinctions suddenly dont seem so easy anymore. so you either f*** it and give up or you spend all your time studying. thankfully most of us buckle down and do the latter until we start to realise, oh no, we actually have no life. what do you do besides med? hmm grocery shopping, occasional tv, more med? i mean after starting medical school, ive stopped riding, playing the violin and piano, and i wish i could continue my french and surfing.
And then sometimes, (alright, ALOT of times) you start second guessing yourself. that maybe im not smart enough for this (there somehow always seem to be 1 christina yang in every tutorial, and somehow that christina yang is never me) or im just never going to be good enough, im an imposter in med school. (i remember in the 2nd week, alot of us felt guilty carrying the stethoscope because it just felt so weird) and you start thinking maybe i should go into something less demanding, something where i dont need to memorise all this crap or even if i forget any of this crap, i wont be killing someone.
But.
i believe that for most of us meddies, we cant see ourselves doing anything else. or at least thats for me. and im sure each meddie have their moment; but for me, its always the adrenaline in the OT. i dont know why people do drugs seriously, its such a high watching surgeries (not to mention especially neurosurgery). and its just before the surgeon makes that cut, thats always a kick for me. Like i said, i love the beginnings :)
At the beginning of the year, we were literally a bunch of morons. Any question asked by the consultant would be met with a stunned stare with severe exopthalmos (eyes popping), before hurriedly rummaging through the medical cards and notes for the correct answer. and pathology was such a killer. the copious readings on top of what we already have to do, the seemingly ungraspable concepts and principles. each week, the pathology case was met with more curses and swearings Thankfully, as the year passes, we gain alot more knowledge, we understand relationships and links, which helps to piece all the mismatched info together. and i always find it beautiful when i finally piece everything together. when everything just makes such nice perfect sense. the body is just incredible. somebody up there (whoever it is) did a fantastic job i reckon.
And being the first year in a hospital, opens my eyes to the behind-the-scenes running of it. Ethics, consent issues all look nice and fancy on paper, but how much is that really practiced? and is there really patient equality? no one would bat an eye at a 3rd year practicing her urethral catheterisation on any ole patient, but if the patient was a doctor, its the senior reg that does it...so yeah. i guess we all have to learn somehow somewhere. 1 patient is always going to be the first guinea pig for us, but its interesting how we try to make it open but hide it all at the same time
Plus, im grateful because ive learnt so much in this 1 year, its like ive been through so much life. i mean honestly, at our young tender ages, fresh eyed and bursting into the world, how many of us actually think about death and dying? (im not counting the emo kids or the goths. they are different) but here we see and confront it each and every day, we watch the patient's triumphs and failures, we see stupid things that people do to 'kill' themselves, and how really life is just too short to waste it. people find out that they have cancer when just 1 week ago they were fine. all you need is a tweak in 1 cell. yup just 1 and voila, au revoir world. and i find that nothing really matters in life, except life itself, as cheesy as it seems, but its true.
ive also come to accept the concept of 'death dying and sickness' a little better. i used to be a bit wary of it, but now, i realised everything in life is in relativity. when theres happiness, theres sadness, hence with life naturally comes death. i wonder if this new 'zen-like' thinking has got to do with seeing it everyday and just becoming immune and detached from it all. hm.
and id definitely remember my very first patient, the first wheeze, crackle, (sounds like the cocoa pops advert: "whizz pop crackle" haha), all the interesting patients, being scared to death by the almighty consultants, happy tea times with the registrars, messing around with the group and nurses, and all the surgeries ive scrubbed in to.
so thats third year over and done with. now to exams and then HOOOOMMMEEE!!! WHOOPPEE!
exams in 2 weeks or less rather...kinda excied about it because that means....IM COMING HOME SOON! awesome huh, and theres so much to look forward to at home, me, wong ying and yil have a travel pact, im going to attach at NNI and much belated shopping and of course see all my dearest friends and doggies!
and i have just realised that ive definitely chose the right path in neurosurgery. haha heres why:
i borrowed the cd of the american board exams (that is after they pass internship) and so its spilt into the different specialities, like cardiology, gastro, neuro etc.
and im well chuffed that i got 85% of the neuro stuff right. but guess whats my cardio score? a miserly 10%. yeah no kidding, i seriously suck. even though i jag chaz (who wants to be a cardiologist) that the heart is JUST a muscle and isnt the least bit interesting, i still dont get the heart at all. even my rheum or gastro wasnt so bad at least i got 60+%
i just get so confused with all the 3rd heart sounds, reverse spilts and what have you. why is the murmur mid instead of late or pansystolic, and i think an ejection murmur sounds just like a pan or late systolic one anyway (maybe i need to have my ears checked..some sort of conductive hearing loss??). and im sad to say i only just understood right and left heart failure recently. (ok fine, like 2 weeks ago), all the other times im just fluffing my way through. yeah i know i should be embarassed and ashamed of myself. heh the only way i got through ward rounds was to memorise all the major diseases and their constellation of signs and symptoms so when i get quizzed i just fit the patient's symptoms into the jigsaw. and ECG. holy shit, boy do i hate that crap. unless the abnormality is staring at me in the face like a huge ST elevation + Q wave, or AF or, best and my fave VF, i wont be able to diagnose any other thing. not good not good. heh thats why i think id make a shitty intern, i only know and focus on one aspect of medicine. which is pretty bad i reckon, hmm maybe next year i shall expand my horizons abit. i cant wait for 4th year and deliver my first baby! whee! we also do obstets and gynae, gp (yucks) and psychiatry (yucks yucks yucks) although i plan to spend my whole psychiatric rotation doing neurosurgery instead. (sorry but im not for the idea of gettting attacked by some schizo patient, half of the code calls in the psych ward is for aggressiveness. no thank you. ) ok thats mean. ah well im just not really into psych..someone else can do it haha. as one of the surgeons once said "is it even medicine?" ah well im not going to answer that haha
the funny thing about this upcoming exam is, im somehow quite blase about it. i hope its not overconfidence that'd bring my down fall -_-. but i just feel like id be fine for it. haha inner peace or something like that. the stuff that we do this year makes so much more sense, its easier to understand the anatomy and physiology if you put it into some context. last year i was just memorising moore and kumar and guyton. because it was information overload last year, i didnt really have time to sit and think it through so i was just regurgitating as much as i can. but now for each disease, i remember the patient who has them, so that makes it stick in my head more. i guess im very much a practical as opposed to theory learning person i suppose. and im starting to love pathology, i love how when you go over it again, things start to fall into place and make sense.
although there are days when im like 'oh no, im so going to fail, 1/3 of the cohort fail and thats only slightly less than half! oh no what if im one of them!' and then hyperventilate. and its a common trend among med students, we hyperventilate alot i think. we worry ourselves sick, i mean, maybe im generalizing here, but carol (whos not doing med) has a paper on wed and yet she just went for a long sunday brunch. which i think is marvellous, i mean if you know it you know it, cramming at the last minute isnt going to help anyway.
exams in 2 weeks or less rather...kinda excied about it because that means....IM COMING HOME SOON! awesome huh, and theres so much to look forward to at home, me, wong ying and yil have a travel pact, im going to attach at NNI and much belated shopping and of course see all my dearest friends and doggies!
and i have just realised that ive definitely chose the right path in neurosurgery. haha heres why:
i borrowed the cd of the american board exams (that is after they pass internship) and so its spilt into the different specialities, like cardiology, gastro, neuro etc.
and im well chuffed that i got 85% of the neuro stuff right. but guess whats my cardio score? a miserly 10%. yeah no kidding, i seriously suck. even though i jag chaz (who wants to be a cardiologist) that the heart is JUST a muscle and isnt the least bit interesting, i still dont get the heart at all. even my rheum or gastro wasnt so bad at least i got 60+%
i just get so confused with all the 3rd heart sounds, reverse spilts and what have you. why is the murmur mid instead of late or pansystolic, and i think an ejection murmur sounds just like a pan or late systolic one anyway (maybe i need to have my ears checked..some sort of conductive hearing loss??). and im sad to say i only just understood right and left heart failure recently. (ok fine, like 2 weeks ago), all the other times im just fluffing my way through. yeah i know i should be embarassed and ashamed of myself. heh the only way i got through ward rounds was to memorise all the major diseases and their constellation of signs and symptoms so when i get quizzed i just fit the patient's symptoms into the jigsaw. and ECG. holy shit, boy do i hate that crap. unless the abnormality is staring at me in the face like a huge ST elevation + Q wave, or AF or, best and my fave VF, i wont be able to diagnose any other thing. not good not good. heh thats why i think id make a shitty intern, i only know and focus on one aspect of medicine. which is pretty bad i reckon, hmm maybe next year i shall expand my horizons abit. i cant wait for 4th year and deliver my first baby! whee! we also do obstets and gynae, gp (yucks) and psychiatry (yucks yucks yucks) although i plan to spend my whole psychiatric rotation doing neurosurgery instead. (sorry but im not for the idea of gettting attacked by some schizo patient, half of the code calls in the psych ward is for aggressiveness. no thank you. ) ok thats mean. ah well im just not really into psych..someone else can do it haha. as one of the surgeons once said "is it even medicine?" ah well im not going to answer that haha
the funny thing about this upcoming exam is, im somehow quite blase about it. i hope its not overconfidence that'd bring my down fall -_-. but i just feel like id be fine for it. haha inner peace or something like that. the stuff that we do this year makes so much more sense, its easier to understand the anatomy and physiology if you put it into some context. last year i was just memorising moore and kumar and guyton. because it was information overload last year, i didnt really have time to sit and think it through so i was just regurgitating as much as i can. but now for each disease, i remember the patient who has them, so that makes it stick in my head more. i guess im very much a practical as opposed to theory learning person i suppose. and im starting to love pathology, i love how when you go over it again, things start to fall into place and make sense.
although there are days when im like 'oh no, im so going to fail, 1/3 of the cohort fail and thats only slightly less than half! oh no what if im one of them!' and then hyperventilate. and its a common trend among med students, we hyperventilate alot i think. we worry ourselves sick, i mean, maybe im generalizing here, but carol (whos not doing med) has a paper on wed and yet she just went for a long sunday brunch. which i think is marvellous, i mean if you know it you know it, cramming at the last minute isnt going to help anyway.
went to watch the australian version of the phantom of the opera last night with anna at princess theatre. i was really excited at first, it being my favorate musical of all time, and when i watched it in london earlier this year it was my childhood dream come true.
and so yeah, there was a lot of hype and expectation.
but omg did they fail so terribly, i wanted at many point a time throw rotten tomatoes and eggs at them.
1. Raoul, was such a terrible singer, that it made my hair stand each time he sang. his voice was so weak, and toneless that anytime he sang solo i could hardly make it out and worse, when the 3 of them were singing their own parts towards the end, he was totally and completely drowned out. he was like a goldfish just gasping for air, with nothing coming out. i was freaking irritated at his lack of talent.
2. the phantom. credit has to be given that he has a good voice BUT he made the phantom into a cariacture. he was prancing around like a petulant child showing tantrums, and of all horrors, he was making monkey poses behind the screen so we see the shadows(eg. flexing his biceps, dancing around) just before he killed the man. i was really mortified, i was like !!! omg this phantom is like a clown, i mean hes SUPPOSED TO BE MURDEROUS!!. and i generally felt that he overacted, he was completely narcissistic in that he drew out his parts sooo long it was really uncalled for.
3. The production was just so unorganised and uncoordinated, even the chandelier dropping was a mess. there was A SIGNIFICANT PAUSE where the crew even looked up at it before it actually dropped. totally spoilt the moment for me. and minor things like the curtains not being pulled up evenly, the music not being on time with the singers. terrible.
4. the cast absolutely didnt complement each other. there was no harmony, everyone was just singing their parts. all the group singings were just painful to hear. sigh
5. Christine was perhaps a slight saving grace, although at her solos, there was some parts where she didnt quite reach the note, and i think the arrangement was changed to cover her singing flaws. but at least she didnt overact
bah. terribly disappointed thats all i can say, even my neighbour fell asleep. unlike the one in london, everyone was rapt with attention, and there was almost not a dry eye in the audience. im not saying the london one was perfect, maybe a 8.5 but this is a dismal fail. geez..
had my neurological MCR today, which is a like a test on how we take a history and examine patients.
so anyway, i questioned the patient about his symptoms which he basically had really sudden weakness in his hands and feet, then it progressed on to his forearm and thighs within a day. It was just so rapid and on that night, he got really worried because he started to lose his balance and not be able to even stand up because he was just so weak. So he went to his local GP who sent him straight to Alfred ED. and while he was telling his history, i just couldnt believe my luck! im like are you kidding me?? this is classic Guillain Barre (plus he had a sore throat presumably EBV last week) and its so rare (its usually the fine prints), like maybe 1-2 a year!! im like wow!!! straight out of the textbook! and he was on the ventilator and stuff..gosh i was so chuffed with being able to see one!
met a really 'interesting' patient today too. Hes a hemophiliac, which means he cant stop bleeding naturally because he lacks one of the factors to help blood clot. (Useless trivia: the royal family in UK are hemophiliacs too) so anyway, last monday he started coughing up bright red blood. and he called his friend whos a GP, who said that not to worry until he coughed up BUCKETFULS of blood...so he just sat there coughing away and then he got really giddy (from the lack of blood) and finally got to his sense to call an ambulance. so turns out he was haemorrhaging in his lungs. what an idiot friend huh! so yeah..and when he got to the rural hospital ED, the doctor on call was like ''so when did you get hemophilia? was it through some infection?'' and he was like ARE YOU KIDDING ME!! haha basically its an inherited condition...so you cant 'catch' it..gosh
has anyone watched the 3rd episode of season 3 greys anatomy??
i think derek made a wrong diagnosis with the boy with increased intracranial pressure. the boy doesnt have a lesion in brocas region because that should cause nonfluent dysphasia, and not presenting with confabulation (the spouting of nonsense). ive seen brocas patients and those poor people want to speak so badly but just cant get it out..so it really doesnt fit the picture
anyway i think its more likely wernickes...what do those who have watched it think??
its been an amazing 6 weeks, i think no word fully describes how fantastic it has been, and im really really depressed that its ending. (plus im going into dermatology and rheumatology for the next 6 weeks...omg can it get any more boring)
its amazing how much ive learnt in this 6 weeks, aneurysms, tumors, strokes..and its great having doov be as crazy about it as me, i think between us, we devoured so many neuroanatomy, neurosurgery and neurology texts. and its really so rewarding when we are able to localize lesions and things like that. I dont think ive ever put in that much effort in any rotation before, its like a 120% kinda thing haha
and the fantastic surgeries that ive got to see, tumors, aneurysms. i know that i entered medicine with the intention of going into surgery, and was more inclined towards neurosurgery, but nothing prepared me for the real buzz of it all..i still get such a huge adrenaline rush when we expose the scalp, and start going into the actual grey matter. honestly theres really nothing comparable to the brain. the intricacies, detail, complexity of it all just doesnt cease to amaze me. and it has such a huge scope beyond what we have now, the up and coming cure for parkinsons with deep brain stimulation and all that, psychoneurosurgery to cure depression
everytime im there, i just feel so right. theres just something about being right at home that floors me i think. have you ever been in something and know for sure thats where you are meant to be? i think thats exactly how i feel..
and im really gonna miss the people. all the people in neurosurgery are just awesome, from the consultants to even the nurses. its like one big family, and especially with the registrars, i think we have got the same wavelength kinda thing, so its great hanging around them, discussing patients and cases or even sitting and drinking coffee whilst talking about bullshit. and as for the consultants, im really gonna miss Dr C, the 400-word man, who likes to test me with 'explain in about 400 words about ....', Prof R, whos just about the most inspiring surgeon that ive seen, and Dr H with his hilarious tirades but his incredible ability to teach.
sigh. anyway, im real chuffed coz im going back to NNI and be attached at the end of the year, so thatd keep me through to the end of the year!
