Back from the run
Just some corrections to make
it's 1.2 MILES per lap, so that makes it 1.8km
I only ran 2 laps before i expired and crumbled to the floor from hypoxia and a niggling knee ligamental ache

SO that makes it 3.6km in about 24 min
Sucky start, but it all has to start somewhere

Will shower, cheers

Started the great fitness program, will attempt to put on 7 kg in the next few months.
started with breaking a sweat first, so this will be the route i'll be running in a short while, which will be total of 4 laps - abt 4.8km
will try to finish it in 30 min

Int Med posting is just about to end in a couple of days time. It's been a wonderful experience learning, not sleeping, staying back late. It's always nice to think back eh, but i guess if u're on call at 5am with another 3 cases to see, and ur MO is nowhere to be found, then it doesn't get that nice anymore. But i think i learnt a lot, but there's a lot more to learn. Was just talking to an MO on call the other day, he said 4.5 yrs into the job, he still has a lot more to learn. I guess it never stops

Just got my hands on a small organiser, think that'll be useful to plan some stuff and organise my time. AH surgery next for me, i hope it'll be good with lots to learn. Hope to spend some time in OT and get my hands dirty.

Off for my run!

Woot, my only day off this month. Spending it resting, eating chips, watching tv. After this comes 20 days of working non-stop. Next call on friday. Dreaded HO1.

Just spent some money pampering myself. Bought myself a new ext hdd, which looks damn sexy. And also the new season of football manager. Halfway through the season, and i'm still 4th in the table.

And i've just started a tab between ED vs Mink
ED meaning emergency department
ED scores a point when they think it's something, i disagree, and i'm wrong
Mink scores a point when they admit for something, and i think it's totally something else without need to exclude what they have admitted for.

So far, the score is...

ED 0: Mink 2

Shall not bore u guys with medical details

Switching between teams every few days, just covering for ppl. It's quite shitty, becuz it means i wun get to know my patients well. And once i do, it's time to move on to another team. But kinda enjoy the freedom to do things on my own. To order, to manage, feeling so much more like a MO now, not just being a scribe.

HOLIDAY!!!

Finally, a well deserved break from SGH. Just spent the day with dyan, slacking, watching videos, cooking, basically doing nothing much. It's just a damn sian thought, knowing that all this is going to end in 4 days. But it's also nice to know my next holiday will be 6 days long! But that's a good month plus away.

Sigh...

But anyhow, i'm going to spend these next few days having lotsa fun. Sleeping anytime i want, anywhere i want. It'll be good if i'm slacking in cameron highlands though. Sipping fresh tea, having cool air, warm campfire. But i guess this will do as well. Aircon, cold coke and lots of dota will do the trick.

Think it's going to be a slack 2 weeks. There are now officially 6 HOs in my ward. That's disgusting. I have only 10 patients on my list, thats even more disgusting. And the worst part is that i am actually trying to dig deep into the history to see if there's any more to the problem then D10 abx, plan: cont abx. Jiashen just had a case of hypothyroidism, causing rhabdomyolysis -> raised CK. but the mystery has not ended, no raised aldolase. Many more mysteries to be unravelled with time.

My colleagues can have like 3 patients on their list. Think they must have bored their pi gu off. Have a couple of new HOs to my ward, brand new from med school. So still trying to guide them regarding bloods, procedures, simple things they can use to make their life easier. Still a bit slow, a bit clumsy, but i'm sure they'll make good doctors in time.

It's even more fun rounding alone, can just order anything i like. Works my brain a lot more compared to LSCS and NVD.

SGH medicine. Known for it's ferocity. Each call you do is like going to hell and back. Next day comes along without post call. You slow down to this snail pace, and turn into a zombie. But surprisingly, i'm actually enjoying it. It's just a bit scary at times, when u dun know wat to do when u're on call and u are first line in defence. Other den dat. it's actually quite fun, learning the finer art of doctoring, communicating. Never a day passes where i dun learn something new, doses of drugs, knew ways of looking at lab results.

2 weeks have passed, another 3.5 months to go. 18 more calls. Scary.

Went to donate blood today, and i had to recite every single place i've been to in the past 3 yrs to the MO. It was quite a list, and i'm quite surprised i had managed to go to these places in such a short span of time. Was just thinking of all the fun things dat i can do in 5 days. Any suggestions?

Ever did something totally out of your mind? Despite warnings of ppl telling you not to do so. Even more so dat after you did it, you actually question yourself why you even did it to start with? Happens to me all the time, and it now leaves me feeling like crap.

But then again, everytime i feel like crap, i start to appreciate those that are most precious to me. I start to move myself away from the crap dat happens, and care for those who care for me. And it's these time of crap, dat i think through i want to do at the end of the day, how i am going to go about achieving it.

Crap will come to an end sometime. Crap can't last forever. And most of all, i can imagine myself laughing the crap away 5 yrs down the road, as i am, laughing away crap dat has happened throughout my life.

So remember, the next time you think u are receiving crap you dun deserve, heads up and walk on. Someday, the person who mocks at you will receive their fair dose of crap.

Btw, i love crab, which is not to be confused with crap.

It's august. 3 months into the life of being a doctor. 3 months of being utterly exhausted. And all of a sudden, i just sat back and stared at my table, and realise dat something is amiss.

My table's a mess, stuff strewn all over the place. Letters which i have not opened for weeks. Piles of books and journals. Credit card application brochures. MOH guidelines. 2 day old cup of coke. Cables and old rough paper.

I turned around and saw the even greater mess. The wardrobe has clothes not neatly packed. The ground is stacked with old stuff. The books are everywhere. My trash bin is full and overflowing with papers.

Looking beyond the mess, i see a even greater mess in myself. 3 months of work, and i dun see myself being much better off. The bank account is still empty. My medical knowledge is still lot to be desired. Still having bad karma as usual.

Nothing much has changed.

Today i've finally crossed swords with her royal highness. Thought i could survive 4 months without having to ever cross her path, but i guess dat was wishful thinking. Interesting way it unfolded though.

There was this post-op review dat i was supposed to do, but i was busy, and my fren who popped by, offered to help me, which i of course jumped on the offer. But perhaps my fren was not too familiar with the post-op orders, so he told the patient something not so right. Just happen dat this patient belongs to the royal highness, so while i was walking down to have lunch, i received a call. And there was a 5 min lecture on wat i "said" wrong, cuz the review was chopped with my name. Somehow i reflexly said i didn't say anything like this to any patient, den i realise the next questions she'll ask is who did? Sry bro... couldn't keep you out of it...

So another 5 min of if us 2 seen this patient, should indicate in the notes. If not i'll be held solely responsible for wat happened. And how this is bad documentation.

A few lessons learnt from this episode

TRUST
I trust my friends very much, and will still do. I think it's impt to have trust in each other's work. Sometimes when i do discharges, i realise dat the hx and past hx is very skimpy. So much so dat a lot of the past hx is often left out. I've lost count of the times the coder comes up to me and ask me to write a piece of past hx of this patient. Impt things like depression, heart valve disease are all not mentioned, but it's all in the old clinic notes. Perhaps just a quick flip of the old notes to see wats relevant would be good. I think no matter how busy we are, we have to take responsiblity over the patient, and give them our best, even if it means skipping lunch or being late for something. Make the clerking sheet the most useful piece of info u can leave to ur colleagues.

RESPONSIBILITY
The feeling this place gives me is dat of competition. Very strong competition, like ppl are trying to outshine each other. Not so amongst the HOs maybe, becuz a good number of us didn't quite choose this. I dun like this feeling.

Reponsibility towards my patients is my top priority. I'll leave the "competition" to those who deem it as impt.

LEARNING
Not much education takes place at work. I think formal teaching is not very useful. More useful is the day to day work, and questions we ought to bring up along the way. But everyone is too busy to spend 5 min to explain to u something.

Trying to educate myself though talking to the support stuff, like nurses.

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Work has been fun. Been enjoying talking to the nurses and the coder. They have such a wealth of experiences to share, be it about life stories, patient care, medicine, doctoring to even wat sri lanka is like. I enjoy having to do rounds alone before the consultants come and r/v the cases. Makes me think. Think you stop thinking and learning if u do the same thing day in day out. Must always take home something everyday, think dats wat Prof Low told me once. Be it learning about the management for a condition, or setting a plug faster, or the patient's social hx. Something new everyday keeps you going.

They say HOship is tough. I think it's just tiring, as much as exciting.

Reading "The Little Prince" now, thnx to ley shuang. She left it in my MO room one day. It's a relli good book.

Been a long 2 weeks dat just passed. Being in the slackest posting, i still feel tired. And very lazy. Dun know how ppl can tahan a 7-day work week. And my turn is fast approaching.

The weekend is passing faster den i hope it to be. It's a rather boring weekend. Everyone's on call, there is no more soccer, and i'm starting to get bored playing DOTA alone. I think i'm very lazy. I can actually think of some things i want to get done. But i'm too lazy to move my butt beyond the confines of the house.

Been losing weight recently. It's odd considering ppl always say dat you'll gain weight in obgyn, cuz it's so slack, u spend ur time eating. Maybe i should relli start some exercising regime going.

----------------------------------

Expectations is an interesting thing. There are those instinctive expectations, like as if it's been engraved into my genome. Like how i would expect myself to excel in most things i do. Then there are those role-related expectations, like how i would expect the meepok man to cook a mean bowl of meepok. But slowly with time as i age, these expectations start fading. It gradually mellows.

With expectations, come disappointment

Disappointment comes along when ur expectations are not met. Like how i fail to do better to get the postings i want, or how i fuked up my A levels to land up doing this. Or if the meepok man cooks up a bowl of kwaytiao-teng, when u ask for meepok with lots of chilli. It just feels different. It damn feels shitty to not be in control.

After disappointment, comes acceptence

There will come a time, when u know u cannot fight the beast. You admit defeat, dat no matter wat u do, you cannot change wat is already there. You realise dat you are a loser, but perhaps a easier way out, is to convince urself dat it's alright. You tell urself, maybe things happen for a reason, maybe there's no point pursuing the issue any longer. You give up, and give in.

Life goes on. With a smile, and a tear.



That's the guide (surya) and our handsome porter (deepak). Resting at Tal, and right behind them in the background is a couple of waterfalls.



One of the cascades we came across. I kinda like these waterfalls a lot more den those single big tall ones.



Benny and Chin crossing over to the other side of the river gorge.



Our first glimpse of the snowy mountains.



Annapurna IV in the horizon

Day 4 of a long 2 weeks, with a weekend call right in the middle. Many ppl tell me that O&G is a very slack posting, get to go home at 4.30, calls you do nothing, etc etc. But i rather think not so. It's probably true dat u can relli slack and probably just fulfil ur duties as a HO, which is not dat little btw (i only finish the changes at 6pm today), since a lot of the responsibility rest on the hands of the MO instead. In fact, there is very little we can do. I was hoping someone would teach me how to VE someone, but apparantly we are not allowed to do dat.

I think, it's a question of how involved you want to be. You can relli be part of the team, or u can just be a scribe-bloodsucker-formfiller-drugprescriber. Quite enjoy working with ppl i dun usually tok to. So far been working with 2 rather hardworking ppl, ppl who dun push off their work, but actively attempt to finish more in less time. James is as inquisitive as me, though we have lotsa questions with no one to answer them.

Stayed back today to deal with some AOR (ie zaoing against medical advice) cases for benny, who's on call. Realise it's relli not easy to convince someone to stay, without sounding threatening or rude. Think i have a lot more to learn. In fact, everyday i learn something new, some from the mistakes i make, some from looking just plain ignorant and dumb. Maybe dats wat u mean by experience. It's even enlightening to have some senior tell u in ur face "you again? how come i can't get rid of you?". I think he means it. Though i haven't figured out why the hate.

I think part of the fear of the job comes from actually not being quite sure what ur job entails. Like arranging a crash C-section for the first time, or getting consent for the first time, or even writing amoxycillin 500mg tds for the first time. But i realise once u know wat to do, the job isn't quite as scary anymore.

Still adapting, and O&G is good, since it also teaches me surgical skills. Think in no other surgical posting do u get so much OT exposure. Even doing an episiotomy repair is interesting somehow. The nurses in the OT have called me at night many times to go to OT to assist... haha. Technically 2nd surgeon liao.

Back to the photos. Realise dat i can't quite remember the name of every stop we stayed at, or places we pass. So here are just some photos.



More amazing terraces.



If you look carefully, u'll see a rainbow.



The top of a hill we climbed.



The river bed. Apparantly during the monsoon, the river will flood and the gravel and sand u see will be submerged.



The view from one of the rest places where we had our lunch.

Been a rather busy week so far, not to mention my very first call. It's not too bad, since i'm on call in the labour ward in which i was posted to. The only thing is that i'm covering the duties of 4 ppl , since my partner is often in the OT at night. Early part was busy, but got a bit better. Had time to go help out a bit in the periphery wards, before i manage to catch abt 1+ hours of sleep.

Had to run out of the shower when there was a code green... ha... pamela was laughing her way back to her room when she saw me half drenched.

Been a great learning experience, and i still firmly believe dat nothing beats learning on the job. The learning curve is much steeper, and u learn the practical side of things.

Back to more photos!



This is a shot from the same window i took the previous shot from in the previous entry. Had to cross dat bridge in the middle of the night, so didn't quite knew wat it looked like, until morning came and i looked out. Think i had to cross like more den 30 of such bridges along the way.



The street dat passes through the town. It's quite a nice town, being stone paved.



Donkeys. Lots and lots of donkeys. They are the cargo trucks of the mountains. Everything is brought up either by donkey-power, or man-power. and these donkeys are highly skilled at tackling mountain paths. Haven't seen one stumble or fall off a cliff, despite carrying heavy loads. They do shit a lot though, and if you're following right behind them, they'll fart in ur face.



The nepalese have learnt how to make use of every single acre of flat land to farm. And if they are not flat, they make them flat.



Chin doing his PE-shorts and Army-boots combo

End of the week for the first day of work. Been quite an experience so far, but also learning many lessons from it as it gets by. Some theory, some practical, even how to do a caeserian.

1. Delivery
Never stand at the base of the bed when the baby comes out, cuz together with the baby, and shortly after, is a huge spurt of some icky-brownish stuff, which will land on ur pants and trousers and make u miserable the whole day

2. Plugs
I damn suck at putting in a green plug into a woman's hand. Somehow the canula refuses to slide in. So far failure rate has soared, with today having failed 2/2 (100%) and yesterday 1/2 (50%). Now i have extremely low confidence when i stare at a vein, compared to last time. But if anything, must act confident.

3. Getting lazy
Think with time, after doing many of the mundane stuff and filling in forms, i start to get lazy and not look thru ALL the past hx, which is damn bad practice. I'm determined to correct dat, cuz on looking back at my own papers i filled in, i realised i made quite a few mistakes, all becuz i became lazy.

4. Muscle memory
After a while, filling in the IMR, doing episiotomy repairs, tying knots, giving IV drugs become muscle memory. It just comes with the lift of the needle or the pen.

5. Hand Tie
The hand tie is damn fast. No fumbling with the instruments.

6. Sleep is precious

7. HP
Yes, they do provide me with a new HP, but it's a phone i wish it doesn't ring. Normally is nothing good. And somehow i get called more often then my partner (postulated becuz my name is before his).

8. C-section
First hand experience in the heat of the operation, yanking, pulling, cutting, burning and maybe in the near future tying. Not to mention sucking the baby's throat.

All been an eventful first 3 days at work. And feeling the pressure of responsibility. Hope i make a good doctor.

Today was spent being extra tired. Was fighting to keep awake throughout the talks in the morning, and even through the afternoon and night. I guess keeping myself actively doing something relli helps. A few things i accomplished today.

1. Bought a new pair of shoes (after i sold my previous one to jiashen)
2. Ate AV chicken rice jia gian jia kwa
3. Watched 6 episodes of naruto
4. Convince myself dat my future does not lie in DOTA
5. Ate 2 packets of seaweed
6. PS my JC classmates for gathering

Back to nepal...



Day 1 of the trek, and we were thoroughly drenched. Someone had the idea of doing a "night-trek", which didn't quite go all too well. Its started pouring, and the rain and wind was so heavy, dat at one point in time, i could not see where i was walking to. The rain was pelting in my glasses, and which point in time, i thought we'll be in for a long night. But thankfully the rain subsided after abt 30min.



Got to our first rest stop, which happens to be the most pok of all the guesthouses dat we stayed throughout the journey. But i kinda like it, very basic, have to climb rickety wooden steps to our little wooden cabin.

What u see on the table, is the infamous Dhal Bhat of nepal. It's basically rice (tonnes), some little bit of bitter vege and potato, and Dhal (aka soupish thing). How the nepalese eat is this -- they pour the dhal (which can range from tasty to tasting like water) into their rice, put the vege in, and make rojak out of the whole thing with their hands, and off they go.



Benny striking an extremely sexy pose sleeping opposite me. Above him lies all our wet stuff.



The view in the morning from our window. We are in a river valley, and very much trekking our way up the river. It's quite a beautiful sight, since we arrived in the dark and was unable to appreciate the beauty of the place.

Just got back from a mahjong session with the gang. Been a long time since i last played with them. Somehow dun have the stamina to last thru one of those crazy sessions in the past. Now play half a dong i already feel tired. Won some money though, so bought the guys supper.

Now to continue with a bit more nepal

This is a shot of the first room we stayed in. Quite basic, even have an attached bathroom, but the hotwater doesn't quite work. So we come out of the place freezing. Kathmandu is actually quite cool at night, being at cameron highland's kinda height. Managed to bargain this room to abt sgd30 for 2 days, meaning about sgd4 pax/night, which is quite the standard price.

Dat's me writing my travel journal by the window, which happen to be looking straight into another window abt 3m away, which was occupied by some angmohs. Interesting views from this window of the opposite room... haha.

Spent the next day wandering around kathmandu, and eventually venturing out of the maps dat we have. And so we saw the real kathmandu, the narrow streets, half completed buildings, and rubbish everywhere.

This is a view from the top of a building in Thamel, which is quite the tourist center of kathmandu. Lots and lots of guesthouses here to choose from, and of course a huge variety of very affordable ang moh food.

Just realised that there is actually a cap on the amt of space my photos can take up in blogspot. And since most of my photos are close to 1mb in size, maybe i should shrink them down before i upload them, which is actually quite a hassle... haihz...

ok, since i have nothing much to blog about, and i have tonnes of time to spare, maybe i'll just blog abt past trips dat i have la. Thought these are a bit more interesting den blogging about day to day stuff, which i can't blog about very soon, since i'll be sued if i reveal abt patient's confidentiality.

Think we can start with some photos abt nepal den, which is my post-grad trip.

This is the gang at changi airport early in the morning. Managed to secure a taxi ride from leonghai the night before -- though i probably underpaid him. All still looking fresh from the end of MBBS and ready to chiong some nepalese mountain.

Dun quite know how i managed to convince them to go on this trip. Think i'm quite good at selling "tour packages" to ppl. Maybe i should be working in the travel industry instead.

Airport at Kathmandu. Which is actually very basic. It was actually quite hot when we arrived, despite being 1.4km above sea level. Had a bad experience with some guy at the airport, who was offering to help us grab our luggage and push our trolley. Told him repeatedly dat we dun need his help, but he kept on going. Had the feeling he'll ask for a tip, and eventually he did. Told him firmly no, and he stormed away looking extremely displeased. These ppl dun get it do they?

Need to head off now, ciaoz

First post

Hmmm, this does seem to be much easier to use den blurty. And more importantly is the ability to add photos in at the click of a button! Or dat is at least i think... let me try...














Wow, nice. Still figuring out how this thing works. Anyway, this is a photo of the various beers we tried in Nepal. If u are going there, pls give the one on the right a miss. Oranjeboom or something. Taste horrible.

This photo thing doesn't seem to be well aligned... no WYSIWYG (pronounced Wee-See-Wig). Been a long time since i last used this abbreviation. Still recall the old days of Wordperfect and Coraldraw, now very much superceded by Microsoft word and Adobe photoshop

Will throw more photos in at a later date, perhaps some on my recent trip to nepal. It's a relli beautiful place. Lots of unfinished business over there.