Monday, November 09, 2009
life lessons learnt
i owe alot of my interests to my primary 4 class teacher, mr thomas. he got me hooked onto roald dahl, trivia (we were freakin' 8 years old and we knew that paul keating was the prime minister of australia at the time) and music from an era far removed from mine.once in awhile he'd bring us to the school hall, sit us down near the piano and teach us to sing songs like "ticket to ride", "scarborough fair" and "love me tender". he told us stories of how his parents used to throw his records out, calling rock 'n' roll the devil's music, and how he'd quietly buy more 45s anyway with money that he had meticulously saved.
although i had a music teacher in school here in malaysia who taught us to sing "morning has broken", the feelings i have attached to music by elvis, the beatles, simon and garfunkel are very different from the ones evoked every time i hear the-artist-currently-known-as-yusuf-islam's song on the radio. till this day i find it hard to stomach the latter, while the fab four never fail to bring a smile to my face.
it's because of that that i remember mr thomas very well. there must have been something special in the way he imparted knowledge to us and inspired us to learn. he must have had a talent in teaching that made my primary 4 experience so memorable.
recently, my father asked me just what i learnt during my time in quarry bay school. we didn't have fixed subject periods and we didn't have formal assessments. at the end of the school year, my parents received a letter detailing my progress in several fields - math, language, social skills, behaviour, etc. - but there were no grades, no clear indication of how much i have learnt.
come to think of it, it was a rather strange form of education. well, strange to us A-crazy malaysians anyway.
but when i look back at the time i spent singing those songs with mr thomas and the rest of my class, i realise that what i picked up was how to love every aspect of life that is available for me to love. that's probably one of the best lessons i have ever learnt.
lishun at 3:00 AM
Sunday, November 08, 2009
eternal spring
perhaps i really am a snob.i sat through a luncheon celebrating the 85th anniversary of the malaysian eng choon association thinking that i don't belong there. my father and sister are both active members and i grew up attending their events, winning their book prizes, going for dinners that my father had forked out thousands of ringgit for in support of the association. yet i have no desire to follow in the footsteps of my dad and older sibling and join the association in the future.
my father was born in eng choon, or yong chun as it is known in hanyu pinyin. he has cousins who continue to reside in china and he keeps in touch with them via snail mail and the annual phone call during chinese new year. he's got strong connections with the place despite spending most of his life here in malaysia and a number of years in various countries around the world.
as for my sister, she seems to have inherited some of the responsibility my father feels towards the eng choon community in the klang valley. i've never really understood it, but maybe it has something to do with the fact that she's the eldest child of a man who is relatively well-known in the malaysian chinese community and hence cannot help but have some of that...stuff(?) passed onto her.
i have never felt that way. perhaps it's because my only real exposure to being chinese chinese is at home, where the lingua franca is mandarin. i went to a sekolah kebangsaan, spent 2 years in an english medium school and my closest friends read books like "to kill a mockingbird" and listen to robbie williams. i don't feel any connection whatsoever to my chinese roots - save for my love of dim sum and teresa teng - so being in that hall this afternoon, among some of the most distinguished persons in the malaysian chinese community, i felt completely out of place.
both my parents originate from eng choon (no, they didn't get married in an arranged marriage as kids, don't get the wrong idea), a province in china with a beautiful name that translates loosely to "eternal spring", and i am a 1st generation malaysian who has mentally severed my roots to that place.
i'm not sure if i should count that a shame, consider myself a snob, or rejoice in the fact that i identify myself as being more malaysian than chinese.
lishun at 7:19 PM
Friday, November 06, 2009
uplifting
this morning, i talked to an old man with a lung infection. i had specific reasons for seeing him - he had an interesting disease that had some good learning points for myself and the junior i had dragged along - but it didn't seem right to march up to him and say "uncleineedtoexamineyourhandsandtoesandauscultateyourlungsmayipleasedosokthx" so i took some time to just have a chat with him.i wondered where his wife was and he told me that she had been admitted in the ward downstairs for chest pain. there wasn't anyone available to feed him lunch later so could i please tell the nurses that he needs to be fed? after sorting that out, i told him that his oxygen supply has been reduced and that's a good thing, and updated him on his condition.
the whole time i was getting a little agitated, thinking that i will never be able to slot a quick examination in at the rate we were talking. however, i remained patient and gave non-verbal cues to my junior to be patient too. before i knew it, the old man was smiling beneath his non-rebreather mask and giving praise to God for the little improvement that has occured.
he thanked God in short, broken sentences, pulling off his mask at one point to proclaim that "God is our creator", God knows all things and that doctors are healers who deserve a place with God in heaven.
i was amazed by his...fervency in praising God even in the midst of an illness that could kill him before his age does. an illness that has sent him back to the hospital over and over again. a disease that has effectively incapacitated him, confined him to a bed and an oxygen tank.
and still he praised God.
earlier this year, a rehabilitation medicine specialist-in-training told me that he decided to abandon his medical qualification exams after a year because he found it too depressing. i agreed with him - most of the patients in the medical ward have chronic illnesses with chronic complications. furthermore, this being a government hospital, most of the patients are financially insufficient and hence cannot afford the full spectrum of treatment they may need.
but just watching that old man rejoice and give praise to the Lord because he doesn't need as much oxygen as he did the day before and his crepitations have reduced a little...that was the most uplifting thing i've seen in a long time.
lishun at 11:51 AM
Tuesday, November 03, 2009
known case of
my first encounter withas a first-year freshie, i was horrified by the colour-coding system and the manner in which labels were stuck onto patients for convenience sake. halfway into my final year as a student, those labels are second nature to me and i appreciate every little thing that makes life as a healthcare provider just that little easier.
during my paediatrics posting this semester, one of my professors insisted that none of us present our cases with the words "known case of" preceding a patient's list of concurrent illnesses. she made it clear that we should say "the patient was previously diagnosed with..." instead because slapping a label like "k/c/o" on a patient, as is the common practice in htj, clouds our ability to identify and treat our patient's problems.
it left a deep impression on me because it alerted me to the carelessness and apathy with which i sometimes treat the patients i see due to the little abbreviation i see right at the beginning of a clerking sheet. i judge them based on the diseases they have already been diagnosed with instead of viewing them as problems that may still have to be reconsidered, reinvestigated, and have their treatment reevaluated. when i clerk around their past medical/surgical history, i become lackadaisical when asking about their "k/c/o"s because well...they're known, hence they are dealt with already. yay?
of course, a good doctor wouldn't let three simple words get in the way of coming up with a comprehensive problem list and doling out an effective management plan and achieving the good outcomes he/she have set to achieve from the very start.
but not every doctor is a good doctor and if my professor - who is absolutely awesome at her job, imho - finds that little bit of wisdom important enough to pass on to us n00bs, it must surely have a significant impact on the way she has practiced medicine...and it should have an equally significant impact on ours.
the insane patient load in government hospitals makes it impossible for things to run smoothly without labeled cubicles and colour-coded files and what-not. however, it is the mental labeling going on in a doctor's mind that may prove detrimental towards the care of a patient.
a patient isn't a "known case of". he/she has a (usually) valid reason for hospitalisation and just had the misfortune of being "previously diagnosed with" some other illness(es). i hope i remember that my whole life.
lishun at 7:52 PM
Thursday, October 29, 2009
tantō please
the samurai warriors had a bro-code of sorts among them, called bushido. one of the most well-known components of that code is seppuku, or harakiri as it is better known in the english-speaking world.when a samurai warrior faces defeat, he commits seppuku to avoid the possibility of capture, torture and the infliction of further shame. if found guilty of a capital offence, a samurai warrior could choose to die by disemboweling himself with his tantō or wakizashi instead of being executed.
and then, there is seppuku committed by a disgraced samurai warrior, who has failed in performing a task set upon him by his master.
---
i feel like performing harakiri - literally "cutting the belly" - right now.
for the first time, i prided myself on actually looking out for every sign pertaining to my patient's condition and i still managed to miss them. i MISSED them! even after LOOKING for them! like seriously!!!
what on earth have i done to deserve medical school? i don't deserve an mbbs with the atrocious mistakes i am making! i have wronged all those students who didn't get scholarships and couldn't gain entry into medical programs because seriously? they would have picked up soft murmurs even in a child with tachycardia and they would not have missed dysmorphic features on a kid with a "mature" mother. no, they wouldn't have.
but i did.
worst of all, i have failed every single one of my dedicated, inspiring lecturers. i have disgraced them while disgracing myself. howla to be dokter liddat?!
sigh. where's my tantō?
lishun at 4:36 PM
Tuesday, October 27, 2009
tuesday morning
ever had one of those nights when you go to bed knowing that no amount of sleep will have you waking up refreshed and ready to go?it's now 4am on a tuesday morning and i've had one of those nights. funny it was a public holiday yesterday, an occasion associated with lazy siestas and pasta dinners. instead i woke up with a headache that sustained throughout the day, paid a visit to a patient with an antenatal follow-up card as thick as a novel, and returned to a hot and stuffy room which further exacerbated my headache.
i went to bed at 830pm, knowing full well that even if i should wake at 730 in the morning (which i can't afford to, considering the amount of work i have to complete before i head off to the hospital), i'd be as lethargic as i was before i closed my eyes. it was so unbearably hot that i took a quick shower and opted to lie on the cool marble floor instead of my bed. as a result, i had short, fitful bouts of sleep before i managed to doze off about 10pm.
a phone call from someone i haven't heard from for a long time jolted me awake and i cursed under my breath, remembering why i usually put the phone on silent at night. it was an unwelcome call and i had to restrain myself from dishing out a good bit of sarcasm at the offending party before terminating the call, silencing the phone and going back to sleep.
i woke up even before the 3am alarm went off.
it's now almost 430am on a tuesday morning and it's gonna be a loooong looooong day.
---
*edit (at 715am): great, now i've got the runs as well. urgh.
lishun at 4:05 AM
Saturday, October 17, 2009
dreams
when i was 8, i wanted to be an archaeologist. it probably had something to do with the fact that i read nothing but books on dinosaurs for the most part of my time in hong kong. i shared those ambitions with my father one day and he responded with a dry-as-ice, "well, you'll probably dig for more than 20 years and if you're lucky you'll discover a new species of dinosaur, but you're more likely to not find anything at all and die penniless."
it's not a very pleasant memory but it has found a itself a home inside my head, emerging to haunt me every now and then. perhaps i have my father to thank for teaching me about separating dreams and reality at such a young age, i have him to thank for moulding me into the rational, cynical person i am today. then again, i sometimes wonder what would have happened if i were given permission to dream and give those dreams a chance.
i have never tried to hide my impatience at knowing what the future holds. i want to know now, nownownownowNOW, so i can sleep easy knowing that i am on the right path or, if i have taken a detour, get my arse back on track. yeah, i will (hopefully) get my mbbs next year and serve 5-10 years of my bond so that part of my life is pretty much secured, but what happens after that?
i am so certain that i won't be a physician for life that i am beginning to doubt those certainties. my desire to work for an ngo one day is probably fuelled by ego-centric self-glorifying motives and it scares me that whatever i am working for today is going to be useless for tomorrow. that i will be of no use to God. dispensible. gone awry.
it's easy to quote scripture (jeremiah 29:11), it's another thing altogether to believe it wholly and completely, with no impatience or frustration. i am impatient and frustrated. i want to know where the heck i am going. i want to be sure i'm going the right direction.
i don't want to wake up one day and find that my dreams, the ones that were quashed long ago, were what i should have chased all along.
lishun at 11:16 PM
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