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Credits go to...erm...John Eldredge, I think, as I first read this in a book he wrote.

Once upon a time there lived a sea lion who had lost the sea.

He lived in a country known as the barren lands. High on a plateau far from any coast, it was a place so dry and dusty that it could only be called a desert. A king od coarse grass grew in patches here and there, and a few trees were scaterred across the horizon. But mostly, it was dust. And sometimes wind, which together make one very thirsty.

Of course, it must seem strange to you that such a beautiful creature should wind up in a desert at all. He was, mind you, a sea lion. But things like this do happen.

How the sea lion came to the barren lands, no one could remember. It all seemed very long ago. So long, in fact, it appeared as though he had always been there. Not that he belonged in such an arid place. How could that be? He was, after all, a sea lion. But as you know, once you have lived so long in a certain spot, no matter how odd, you come to think of it as home.

** **

There was a time, many years back, when the sea lion knew he was lost.

In those days, he would stop every traveler he met to see if he might help him find his way back to the sea. But no one seemed to know the way.

On he searched, but never finding.

After years without success, the sea lion took refuge beneath a solitary tree beside a very small water hole. The tree provided refuge from the burning rays of the sun, which was very fierce in that place. And the water hole, though small and muddy, was wet, in its own way. Here he settled down and got on as best he could.

** **

Had you journeyed in those days through the barren lands, you might have seen the sea lion for yourself. Quite often in the evening, he would go and sit upon his favourite rock, a very large boulder, which lifted him off the burning sand and allowed him a view of the entire country.

There he would remain for hours into the night, silhouetted against the sky. And on the best nights, when the wind shifted to the east, a faint smell of salt air would come to him on the breeze. Then he would close his eyes and imagine himself once more at the sea. When he lay himself down to sleep, he would dream of a vast, deep ocean. Twisting and turning, diving and twirling, he would swim and swim and swim. When he woke, he thought he heard the sound of breakers.

The sea was calling to him.

** **

The sea lion loved his rock, and he even loved waiting night after night for the sea breezes that might come. Especially he loved the dreams those memories would stir. But as you well know, even the best of dreams cannot go on, and in the morning when the sea lion woke, he was still in the barren lands. Sometimes he would close his eyes and try to fall back asleep. It never seemed to work, for the sun was always very bright.

Eventually it became too much for him to bear. He began to visit his rock only on occasion.

"I have too much to do," he told himself. "I cannot waste my time just idling about." He really did not have so much to do. The truth of it was, waking so far from home was such a disappointment, he did not want to have those wonderful dreams anymore.

The day finally came when he stopped going to his rock altogether, and he no longer lifted his nose to the wind when the sea breezes blew.

** **

And so,

I've acquired the reputation of being a Celine Dion fanatic, simply because I was caught listening to her rendering of Beauty and the Beast on Youtube in the doctor's room after going to watch the musical in question.

The musical, performed at the Empire Theatre was better than I'd hoped for - I was actually quite excited about going to watch it (more so than I should have been, according to the prevaling opinion amongst the infectious diseases team).

The original 1994 movie being the first movie I've ever watched in cinema, kind of brought back memories...which were quickly dispelled at the start, with Belle's voice being a bit too squeaky (I thought).

Gaston, Lumeire and Cogsworth carried the show at the start, and by the time the iconic ballroom scene rolled around, we were all enjoying ourselves.

F I N A L L Y !

I've never felt so nervous just before an hour's drive before. At least, not since my first 2 attempts at this British driving test which have left me frustrated both with myself and with how candidates are graded.

So the sense of relief upon hearing the words, "I'm pleased to tell you that you've passed" was almost palpable.

Now, which car to get? Suggestions?

And Sarah, you're right - this is super funny - for all generations of IMU students!!

Star Wars Awesomness

This is, as they say, better than Episodes 1-3 put together.

For a muc much better version, watch it here.

Until I find time to blog seriously again..

Where I find rest

Turning out to be a good week, despite not going anywhere exotic for my last annual leave of this year.

Transformers 2 which I watched a couple of weeks ago, was good. One long adrenaline rush after another made for a very tired group of us who stumbled out 2 hours later that Sunday afternoon. The next week we confessed how we kept imagining how everything around us would start transforming - wonder if it had that effect on anyone else?

A load of books are keeping me occupied for now -

Alexandre Dumas's Three Musketeers is one that I've read in abridged form when very young, Little Women is a heartwarming story about 4 sisters growing up, very much in the vein of Anne of Green Gables.

More to the present, The Boy In Striped Pajamas is surprisingly cute to read - its told from the viewpoint of Bruno a nine year old boy who is sent to 'Out-With' and who befriends a boy 'in striped pajamas' on 'the other side of the fence'.

The Corner - A Year In The Life Of An Inner-City Neighbourhood looks interesting on the outside, I'm hoping for an eye-opener here. And finally a couple of books from the WesleyOwen sales, which I'll write about when I've actually gotten down to reading them.

Oh, and a travelbook, namely Stephen Fry in America, which I spent most of my afternoon in the park reading today, also made into a BBC series which I'm waiting to watch.

Work? What work?

When You Believe

Have been looking for this version for a while - it keeps getting taken off youtube I think, so enjoy while you can!

Movie Week

Not a whole week of movies -just a couple:-)

On Sunday - Erik ditched his long-suffering wife to join Kenny, Becky and I for Terminator Salvation. Something that I'd wanted to watch ever since watching the trailer but had been put off by the poor reviews I'd heard about.

However as Becky put it, the fans who had stood through the downer that was Terminator 3 were not going to miss this summer's addition to the Terminator universe.



A purely action-packed movie, with an emotionless Christian Bale playing John Connor and a slightly more interesting cast paling beside the machines - iconic T-600s alongside Hunter-Killers and a gigantic robot that looked like it had been plucked from the upcoming Transformers movie and was slightly confused to be played beside smallish humans.

Overall - better than expected, but its no Star Trek.


Next - watched this one in my room over dinner and pizza after an unexpected break when David reminded me that he was covering my on-call shift this evening. A movie about Joshua Jackson being told that he has only One Week to live.



A fairly good movie - a lot of Canada is shown (not that I know a whole lot about the country itself), the movie plays out pretty much as expected - there is the moment of epiphany, the moment of sobering realization, the moment of desperation, the moment of fear, the moment of discovery - however the best thing about this movie by far is not its moments.

3 words.

Best. Soundtrack. Ever.

I'm trying to find out how to get a copy of it - the soundtracks are played by Canadian indie artists and established bands, and the sound, while probably a little too light and poppish in parts, is just the right amount of quirkish individuality to pull off a show like this.

Both shows then - well worth a watch!

Time to get down to some work..

Black Is Traditional!

Coraline.

Amazing stuff.

Not having read the book, I watched this with the anticipation of a Neil Gaiman fan collective resting on my consciousness and a middling trailer seen on Apple.com.



It didn't disappoint.

A story about a young girl bored with her parents, and who thinks her parents are bored with her. So she finds new parents, who look just a little odd.

Definitely not a typical feel-good Disney/Pixar variant, which was refreshing. Scenes flipped between the eccentric to mildly amusing to an anticipation of an exciting finish. This is the sort of book I would've loved when I was young. Maybe even now!

The website was the icing on the cake - plenty of fiddling to be had for those with plenty of time on their hands.

Buttons anyone?

Bit s and Bob s

Actually just a bit.

Heard that Coldplay's offering their live recording LeftRightLeftRightLeft as a free download here.

It's got some classics plus some ones off their latest album.


Can't believe its so soon till we finish our first year as junior doctors.
In the space of minutes we'll morph magically into SHO equivalents, expected to make decisions on discharging/admitting patients/sending patients to intensive care/taking over complicated patients from junior doctors - wonder if I'll be up to the challenge.

It does sound like fun though, so we'll see.

Plus, this weekend, if it pans out, should be fun!

PS: If you've still got an appetite for legally obtained free music, check out Amazon's free MP3 site.

Etsu

The last time I ate Japanese, I threw up.

My sister is a big fan, my last housemate back home, my cousin and countless people I know swear by their sushi, sashimi, sake and every raw food that ends with a vowel, so I decided there must be something to the whole cuisine that I'm just not getting.

Etsu was somewhere we've been planning to go for a while. It was the 'place we would go for our first paycheck', then the 'place we would go for our second paycheck' then just 'arrggh are we ever going to go to that place'. Jack, Gil and I planned to make it a house affair, Esther and Naomi, always game to try out a new place, decided to join in.


Restaurant of the Year 2008 in Liverpool, plus rave reviews online - we were expecting good stuff. Gil was especially excited as she knew the chef from a houseparty not too long ago - turns out he remembered her too!

I think we all came with the idea that helpings were going to be small for some reason, so we might have gone a bit overboard in ordering a mixed sushi/sashimi plate, some gyoza and some tempura to start with, plus a main course for each. To complete the feast, some Asahi and Kirin for the guys and plum wine for the girls.

Now I'm a poor judge of what is fresh and what isn't, but the fish that night stuck in my mind as being 'fresh' from the moment I bit into their bouncy flesh that wasn't mushy/soggy in the least. Grains of rice that came apart easily in the mouth yet held together firmly enough to be moved in small clumps easily by chopsticks. Tempura was pretty normal, however the main courses were brilliant all around.


My unagi-don came with a sweet sauce that was light enough not to be cloying, and went beautifully with the white rice - the unagi itself reminded me of a very sweet ikan bakar from back home - similar texture. The tuna and red snapper steaks that Jack and Gil had were firm and went well with their sauces.


Surprise, surprise, we were full enough not to bother about dessert and instead sat around for an hour or so chatting about random stuff till Naomi had to go home and study for finals.

Definitely going back to try their bento boxes.

Free stuff is fun!

I've not won many prizes via random competitions before, so this was a big deal for me. Being a Waterstone's Cardholder, I rarely receive a parcel from them without knowing in advance, so I was surprised one morning, coming back from an all-nighter, to get a fairly hefty white envelope.

Inside was a letter informing me that I'd won an unproofed edition of Martyr by Rory Clements to read and would I be so kind as to submit an online review when I'd finished.

First of all, I mentally and physically prepared myself.


I remembered entering the draw for the book, thinking that I wouldn't mind reviewing a light historical murder mystery, a little light reading in bed would be fun. At the same time, I was wondering whether I would be able to be objective about it, as I've not read that many pseudo-historical thrillers before (Phillipa Gregory - I'd better read one of hers after this to compare)

What makes a good read, for me, is something I've never thought about; this might be interesting as an introspective for myself!

Firstly, I guess I like it when a book is easy to get stuck into - ie if the language is not too fancy, sentence construction isn't too long . In other words, how 'readable' it is.

I also like it when the scene/setting is painted naturally - ie descriptions flow from the pages naturally, making it easy to picture the surroundings without feeling as if the author is trying to draw my attention to each and every object present in order to make me believe in the authenticity/accuracy of his writing.

Descriptions of food are a bonus, I personally like it when meals are described in books, besides making me hungry, it helps to keep me in the scene, as it were.

Pacing of the plot would do quite a lot to keep me reading. I found books with slow plotlines very dull to read. This goes also for books with obscure references to events that only become clear when I keep reading. However some books reward persistence when the plot picks up a little way on; I found Jonathan Strange and Mr Norrell very hard to get into at first-by the end, I didn't want it to stop.

Books with difficult-to-follow plots are an issue. Most murder mysteries, court-case-based books (John Grisham) are not on my reading list because most of them require a lot of attention to really be able to get the most out of them.

Based on the above, I'm actually quite a superficial reader!

However bearing all that in mind, I enjoyed this particular book, because it ticked all the boxes above. Plus I felt that since I'm not a writer, I shouldn't have been too harsh when I genuinely enjoyed it:-)

Almost

An up and down day - in between attending and assisting in flexible cystoscopy clinic, I managed to lose a USB drive, and post a letter minus the stamps.

And at the eleventh hour, when dinner was in the oven and I was wandering bleary-eyed around the house, Ai Wei's frantic tones via Jack's mobile informed me that I was within 15 minutes of missing the farewell tour of Riverdance.

Having seen them already on DVD, I had some idea of what to expect, but the dancing, the music, the showmanship generally was a sight to behold. Everything seemed so meticulous, from crowd pleasers such as Trading Taps, to wildly crazy dances like Morning in Macedonia, to choral performances and instrumentals; to my untrained eye, not a foot looked out of place.

Sitting back during the intermission we wondered aloud how one of the dancers could twirl on tiptoes while in a squat, and almost immediately get back up and perform without losing her balance.

The musicians were excellent, especially the fiddler, who played immunerable solos and generally kept us entertained for the better part of two hours! Must be something, to be part of such a spirited band.

We were lucky to have got such high seats - AiWei's work, and as they are apparently going to end their run of shows sometime in 2010, about 10 years after they first started (an offspring of a Eurovision performance, I just learned!) so if anyone is still wondering; they're very much worth a watch!

wORSHIP

Song of the night:

At the foot of the cross


What made the most sense:

'I lay all my burdens down, at the foot of the cross.'

I wish I may, I wish I might

Got through today, which I'd been dreading for some time now...

Talked about urinary retention in front of the FY1s at the RLUH, which was strangely more nerve-wrecking for me than I thought it would be-I think its getting up to talk in front of people I'm not that close with that makes me nervous.

As expected, ended up talking fast, and trying to cover too much in too little time. Every time I prepare something similar(which isn't all that often anyway), I seem to picture having a lot more time, and prepare a lot more than I actually need to, with the result of having too little time to say all that I want to say. (I'm sure there's a more efficient way of writing all that out as well!)

Was followed by Jack, who did an amazing presentation on COPD. Amazing because he held everyone's attention via a gameshow aka Who Wants To Be A Millionaire style, and amazing because he included plenty of important points for house officers faced with patients with COPD. Enjoyed revising the FEV1 cutoff points for mild-moderate and severe COPD which I'd totally forgotten after doing the respiratory job.

The rest of the day was particularly busy, but mostly enjoyable - ended the day with an unexpected invite to a drug rep presentation at Mayur, an excuse for urology consultants and registrars to mingle and enjoy free food and drink. Vinny and I felt a bit out of place amongst all the big names and timidly asked for a couple of glasses of coke, while around us, Johnny walker Black Labels were being consumed by the glassful.

To mask the event in a show of actually learning something, the registrars had a couple of talks on recent advances in PSA monitoring, and it was pretty heartening to watch senior doctors argue over the definition of a screening test, and how a receiver operating characteristic curve should be interpreted and what 'area under the curve' actually meant. Kind of reminded me of a long ago evening in Barrow 4th year med school where HP, Ed and I sat down to discuss statistics for exams. Much like then, everyone came to the conclusion that no one really fully understood matters:-)

Dinner was good - and while I kick myself now for not indulging in lassi, it was a good, if brief, night out. If only I wasn't working tmrw.

Happy Good Friday!

Holding my attention

Popped into theatre today for only the second time in my Urology rotation - watched a cystoscopy - basically a camera going into the bladder via the urethra, looking for cancer. The fluffy specks, fronds that swayed in the clear irrigation fluid pumped into the bladder were actually worrying - muscle invasive tumour. A 5-year survival rate of 50%.

Back on the ward, a patient became abusive and took a swing at me as I was examining his chest to detect the crackles and creps of aspiration pneumonia to determine if he should continue on IV antibiotics. The staff wonder: how do we assess the mental capacity of a patient whose family are not immediately contactable? A mini-mental score and a call to the Mental Health Liaison team are in order; plus I shouldn't feel too special about the whole thing; he has taken swings at all manner of staff from SHOs to junior nurses.

Jack and Gil are watching Hospital - a reality programme about NHS and dealing with different patients - too much work for me, I'm glad to come home to Heroes, to a nice cup of hot Milo with condensed milk(!) to the latest book waiting to be read, not to more work:-)

Saw tonight on the Apple trailers site that one of my first books growing up, is being made into a movie. Where The Wild Things Are by Maurice Sendak, to me, was a tale about a troubled child who went to the land of the Wild Things to escape his ominous life at home. Seems that the movie is going along those lines - will be interesting to see how it pans out.

I like weekends

It's nice to wake up at the ungodly hour of 9am, without being jolted out of sleep by the alarm and knowing that, if I chose, I could go on sleeping and no one would be harmed in the least (not that they would anyway).

So had a relatively lazy Saturday where I finally dragged myself out of the house to the Liverpool Empire to catch the Witches of Eastwick. It was surprisingly good, and provided plenty of entertaining moments, though we did wonder about the subject matter and there being plenty of kids around - colorful language and sexual innuendo abounded - parents would have a lot of explaining to do.

The story, for those too lazy to follow the links, revolves around 3 women living in a town small enough that everyone knows who's seeing who, and the conjuring up of a devilishly handsome man that proceeds to charm the lady-folk of the town, with both creepy and hilarious effects.

Here's hoping Riverdance will at least be as good when we watch them in April!

Saturday night saw us at Jody's where a number of Malaysian medics had been invited. It was nice to kick back and chat, if a little too medical-oriented:-) (what an amazing phenomenon that when medics gather, the conversation always turns back to work) and considering his house wasn't too far from ours, we stumbled home at 1am without too much difficulty.


Have decided in bits what to talk about on Thursday (benign prostatic hyperplasia management) and am a little miffed at finding out I am working the next couple of bank holidays.

Things are getting exciting

Grand Nationals this weekend...the nursing staff are talking about going to the races, everyone's worried that the rain will spoil things and recounting hilarious past experiences where people spent ridiculous amounts on a bottle of wine.

Will be watching Witches of Eastwick - of which I know nothing about as of now with Jack, my long suffering housemate with whom I've been out together on more occasions than I care to remember. Gil bailed out leaving the two of us to scrounge around for someone else to share the evening with.

Am feeling a little pleased at having survived today after covering 6 different consultants worth of patients. SHOs who are willing to pitch in are a Godsend.

And Easter is coming up. Wonder if I'm working then?

Its nice when things go right

Had an enjoyable Saturday diagnosing and managing at leisure what seemed to be all the various surgical causes of abdominal pain, all of who came in at nicely spaced intervals so that I never felt rushed to do things.

And while Sunday was a little more free than I'd have liked, I diagnosed my first acute appendicitis.

Its the little things that make me happy.

'Twas a curry lunch saved my life today

Yup, carrying that packed lunch of lamb, dhal poured over white rice and overlaid with fragments of a crispy poppadum around to the various wards certainly helped the day go by quite well.

In THe eNd

So its final - I'll start my second year as a doctor working in Infectious Diseases, then Accident and Emergency, and finally Critical Care.

Should I try to sit part 1 during my first block of 4 months? - yet to be answered.

But

'But let all who take refuge in you be glad; let them ever sing for joy.
Spread your protection over them, that those who love your name may rejoice in you.
For surely, O Lord, you bless the righteous;
you surround them with your favor as with a shield.'
Ps 5:11-12

Its been a while..

Introspective

I like to sit on the fence.

I'm not a risk-taker.

I self-indulge a little too much.

I like to start things, but often find finishing them a real pain.

I actually eat quite a lot of food - I wonder where it all goes to.

'The issues' bother me for a while.

As of yet, I haven't committed towards a definite career path yet.

Commitment is more of an issue with me than I'd like to admit.

A lot of my thinking is shaped by my peers/outside influence growing up - I am not the most original of persons.

Probably the only thing I still enjoy doing now as much as before: reading.

Given an unpleasant experience, I'd be the person who'd rather slog through it, head down, rather than spending time figuring out a way to circumvent it.

If I had time, I'd spend more time building friendships and maintaining those that I'd forged over the years.

My estimation and prediction of group dynamics is not as intuitive as I'd like to believe.

Music to me is more about the melody and harmony rather than the lyrics, which is the opposite of what I'd like it to be.


Making lists is something I like to do - lets see how this one turns out.

Disorgnized

I've got myself a diary, 2 in fact, and am still feeling that there are a lot of loose ends to tie up in my life.

Need to get started.

Happy CNY!

Meeting family in a matter of weeks! - save me biscuits!

To everyone who is of Chinese parentage, upbringing, or enjoys a good hot cup of chinese tea..

So Close

So if I hadn't been getting my National Insurance Number sorted on that day, I'd have been here.

And now with the hospital getting into the news for all sorts of reasons, and with staff being increasingly easily provoked due to the increased workload, coming into work daily is becoming more and more fun.

'We are an acute medical unit'

One of the most quoted phrases I've heard this week.

So I don't know enough yet eh?

I'll show them..

Christmas Dinner @18 Guelph Street!

Prepping after coming back from work.

Watching wedding photos..guess whose?

Fellow countrymen in a far off land..

Food - onion soup worked!

As well as roast pork!

Cheese board...we get more posh every year!

And christmas pud with brandy sauce - props to esther!

everyone gets a slice...notice the crackers!

Gift exchange...and our first proper tree in years!

Relaxing with a glass of mulled wine, basking in the aftermath of a satisfying night..

Happy Christmas!!

Hey all, wherever you are, all over the world, have a happy Christmas and a great run-up to the New Year!

Just went on Amazon.c0.uk, and if you have an account, they are offering GBP3 worth of MP3 downloads, only available on the 25th and the 26th of Dec, so have fun picking out your tunes!

Finally..

Just finished probably the most tiring set of nights so far since I started.

Something that's stayed with me this week, both as a reminder and as something to push me:

'You will keep in perfect peace him whose mind is steadfast, because he trusts in you.' Isa 26:3

steadfast (NIV)
stayed on thee (KJV)
set on you (Message)
(both its inclination and character) is stayed on you (Amplified Bible)
fixed on you (NLT)

perfect peace (NIV)
completely whole (Message)
guard him and keep in constant and perfect peace (Amplified Bible)


As I get stuck into working life my worry is just that, that I'll get stuck into it to the exclusion of everything else. Isa 26:3 for me, is a good reminder to get a life!

So, yesterday...

IN hospital every Friday, there's this massive meeting which EVERYONE in hospital gets tom come to, usually for the hot coffee/croissants to start with, then later adjourning to the lecture hall for a presentation on a research topic.

This Friday just gone however, the hall was packed. Standing room only. What groundbreaking medical event, what life-changing, revolutionary drug/treatment/procedure, indeed what mind-blowing gloopy wonder was being presented? You'd have thought the cure for AIDS, or the common cold was being revealed on stage.

In fact, the hall was super crowded because a doctor apparently was amusing himself watching Youtube, and thought it would be a good idea to show some nurses what he was watching. And as a result, the Royal Liverpool University Hospital invites:


Amateur Transplants


to perform an hour of Christmas comedy, right before the hospital descends into its usual Friday chaos.

I got there late, somehow forgetting this was happening, as as such had to squeeze myself into the 'standing room only' spot right at the back of the hall, from which I couldnt even see the stage, much less the performing duo.

For the uninitiated, Amateur Transplants are a couple of practising doctors (at least, i think they are practising!) Dr Adam Kay, and Dr Suman Biswas who do comedy routines, incorporating a lot of music via keyboards, which makes them rather special, if not entirely unique counting their profession.

They have plenty of Youtube videos, so feel free to check them out! Having heard some of them online before, i was still in laughing along with the rest at the Anaesthetist's Hymn, Finals Fantasy, Take A Look At Me Nan and tons of short bits marrying pop song parodies and medical tidbits that medics (and some non-medics!) would identify with!

At the end (by which time I'd gotten barely a 5 second peep at the stage), the crowd got up to disperse, and being right at the back, I was one of the first out. While looking around for a friend whom I was standing beside earlier, I realised that Adam and Suman had actually sneaked out ahead of everyone to cool off..Feeling suddenly tongue tied, all I could manage was a 'wow, well done!' to which they replied 'yup, that wasn't too bad was it?' before remembering I had a ward round to catch up with and rushing off.

It was only later I'd realised....

I should have grabbed a photo while I had the chance!


Still all in all, a good start to a Friday!

Wondering about a Christmas Party..

but I need to work work work...sigh.

To be a student for the christmas holidays!

Christmas is coming, the geese are getting fat..

This one because of the toy cars/soldiers..


Another classic..

Happy December!

Because I rarely transfer photos,

After packing Christmas shoeboxes

Guitar Hero @ 18 Guelph St.

Matthew St. Music Festival 08

Steamboat dinner

Foundation Year 1 karaoke night

Our church hosting a praise and worship evening

The latest additions to my desktop

One of the last dinners before people started leaving - wonder how Tai Bo's doing now...

daily l IFe

Saw a kid while at the checkout counter at Tescos a couple of days ago - he was no older than 4/5 I think, and he was holding an imaginary mobile phone to his ear.

What interested me was that he was yelling someone's name very loudly into his 'phone', then proceeded to spout obscenities all the while yelling into his hands. His mum stood beside him just waiting for her turn to be served.

**

Have had an unexpected couple of days off this week, which is good. Funnily enough I don't seem to be doing things that I'd like to be doing (spending more time wandering the wastes of Fallout 3 or overseeing naval battles in Red Alert 3 or catching up on my reading), but am caught up with other stuff, sleep being a major part.

**

Did shoeboxes for the Christmas Child thingy again this year. Was fun intro-ing the project to the students and seeing ppl get excited packing boxes for kids. Discussing this with another yearmate of mine over Mexican Sunday lunch, it seems we sorely lack awareness of what's going on around the world, and as long as everything's peachy in our little corner of the world, we're content.

On that note, if anyone wants to contribute to our Water Buffalo Fund, let me know:-)

**

Christmas IS fast approaching...this year being my first one working through it, didn't really strike me until after going through the streets on Sat, and on planning for Christmas over dinner last night. Was talking with pastor about how Christmas was like back home, prepping for carolling 23/24Dec till all hours of the morning, with hot porridge to follow, and a early 25th morning wake-up call for the Christmas service in church..

This year, it'll be at a friend's house, a barn dance from which I need to go home early cos am in to work the next day, and work during New Year's too. Oh well, looking forward to coming home in Feb if all goes according to plan.

**

'Worship is the preoccupation of the heart, not of its needs or blessings, but of God himself.'

Obviously in a Christian context:-) still I thought it was so apt as I tend to consider the first two parts a lot more nowadays.

**

Planning a night out for the doctors I've worked with is harder than I thought it would be. I need to set a date, then let everyone know, then pull it off.

**

Waking up

Was in the middle of a ward round this morning, we'd just exited the bay, and I'd gone to get a drug chart for the next patient when the bell went off.

Too often, this happens, everyone rushes to the scene and more often than not, its a patient who's pressed the button by accident or is normally more than a little confused. I began to realise something was up about 5 seconds later, when no one walked back complaining about how the alarm seems to go off for nothing.

My registrar had already started doing chest compressions, so I took his place while he directed the collection of nurses and house officers who began to pile up at the foot of the patient's bed. Chest compressions on a real patient, I'd never realised before how much they differ from the dummy we train on at the clinical skills centre. The chest wall being much more compliant, and not as rigid as a dummy's as well as hearing that give as one presses down..that all makes sense now.

While I was busy counting to 30, IV lines had been set, and gel paddles were placed on the patient. By then, not only the ward doctors were there but the cardiac arrest team had also come up from the ground floor.

Left the patient (someone else took over the compressions) to continue the ward round as my registrar said there were too many doctors about. Only my second cardiac arrest call as a doctor.

Chronicles of a Confused Doctor 5

I had an interesting conversation with one of my patients today.

Someone whom we had had in the ward for what seemed like forever, who was there before I started working, known by name to the staff, most of whom were eagerly awaiting his departure (finally!). I think every ward has a similar story to tell.

ANyway, I stopped by to see how he was doing, figuring it would take maybe a couple of minutes to confirm he was still medically fit for discharge (have to love that blanket term!) and that everything was in order for him to leave the next day.

'I'm feeling a bit depressed today doctor' - not what I was expecting to hear.

He then started telling me about his early days, when he was an infantryman, serving in the battle of Dunkirk, covering the retreat against the Germans. One theatre of war to led to another as he related stories of campaigns in Africa, New Zealand in a wistful manner.

I didn't mind so much, actually, partly because I'm a sucker for war stories, no matter how far-fetched they seem. Also because it seemed like this chap was so keen to relive his past before the end. He knew he wasn't going to be around forever, he said, as he related somewhat proudly that he had 7 great-grandchildren.

'I just wish someone would tell me what was going on. You know, for someone who always used to be in control and fending for himself...I guess I'm just not used to being moved around without knowing whats going on.'

1st question of the study:

Share a high point in your spiritual experience:

Anytime that a group of people gather together to pray for a common topic/person. Amplified if everyone prays simultaneously, and different people raise their voices to encourage/bless/rebuke. When everyone is not aware of one another, as much as they are aware of the presence of God in our midst. When that prayer is to support, affirm, and when we can sense that God is speaking, through someone, a verse, a spoken truth.

1st question of the study:

Describe your ideal vacation:

Would involve a beach with clear water. Somewhere secluded, with not too many people around. Mountains as a backdrop, and plenty of pools dotted amongst smooth rocks. The sand would be fine, minus all the debris left by other visitors, and would extend a fair way into the sea. Inland, a open area ideal for games, and a hiking trail or two, preferably with a waterfall at the end.

Weather should be mild, not too much sun, but warm enough to be able to lie on the beach comfortably, with the odd trade wind coming up out of the sea. Not too much wind though, otherwise frisbee would be out of the question.

Company would be nice, friends that I can have a laugh with, who are not too bothered about DOING stuff, but rather just sitting back and chatting. And preferably friends who share a love for food, of which there should be plenty, at the right times. Barbecues, buffets and the odd packed picnic or two would be nice.

Sounds a lot like Tioman doesn't it? Anyone still have photos from then?

What's Up?

Surfing through news sites, I'm amazed at how much is going on around the world. Whether its the oncoming Hurricane Gustav, Anwar's election and his plans to take over the world..starting with Malaysia, Zimbabwe, giant clams (the next horror movie tie-in?), I feel like I'm missing out on the big picture sometimes.

I was particularly caught up reading the story of the hurricane about to hit New Orleans, and how a general evacuation order had been issued, yet not everyone decided to go. Apart from it being like a scene from a movie, I wonder how those deciding to stay are feeling right now. Desperate for different reasons, to stay behind is not an easy choice to make when roads are filled with people going in the opposite direction.

Could draw an obvious parallel between them and life in general, but don't particularly feel like it just now.

Was encouraged hearing stories from the youth in church about their love for one another and how easy it is for them to serve one another - something we can learn from, especially in the workplace!

Listening to testimonies over the weekend from the youth retreat, it occurred to me:

I've met lots of people who've said they'd believe in God if He would just show some proof of Himself,

'if He's so great why doesn't He (insert miracle/sign) or why does He allow (insert disaster/tragedy) to happen?'

Everyone seems to expect God to prove Himself, leaves the onus on Him, that way, if we do end up going to hell, its all going to be His fault.

From what I've heard over the weekend, God DOES reveal Himself, to those who are REALLY SEARCHING for Him.

Whether its wondering 'where is God in my life', or determining in his heart to go to church 'to find out if God is really who people say He is', or 'because I study sociology, asking questions about the Bible and making myself doubt'.

In some ways, its like looking at 2 pictures:

a kid who says 'can i have ice-cream' and then goes off and plays with his toy train set.

a kid who's looking for his chocolate/ice-cream fix, who goes around and begs,cries,pleads,cajoles 'why can't I have ice-cream?' 'when can i eat?'

I'd definitely find the 2nd kid more irritating, but there's no doubting the desire he's showing.

All roads lead to God.

Listening to the testimonies, I wouldn't say that statement is wrong, its more of our attitude, our desire, our sincerity as we walk our respective roads.

Just thinking..

I Shouldn't Be Putting This On I Suppose....

but...


I got paid!!!

For the first time in my life, I earned something!

wANTED TO WRITE SOMETHING PROFOUND, but words fail me..

Lord, keep him safe.

When someone goes missing, one fears the worst. And I only just heard the news.

Yet hope never really fades.

Spare a moment to keep Yi Jien in prayer, guys.

Chronicles of a Confused Doctor 4

My first death yesterday of a patient under my team. Followed by my first death certificate filling-in today. Didn't get to certify death however, though I actually went through the process with another house officer.

Came out to find that a registrar had already certified death a couple of hours earlier. Think the nurse who got me to do it just wanted me to learn.

On call tmrw from 9am to 10pm on Sat and Sun. So no real weekend for me. Plus the distinct horror cum excitement at holding the crash bleep on one of the two days. Going to have to read the Advanced Life Support Guidelines tonight to jog my memory of when to give adrenaline, and when to not shock the patient.

Here's hoping my worst fear tomorrow is worrying my pants will fall down due to the 2 bleeps I'll be carrying.

Chronicles of a Confused Doctor 3

Two days and I've missed a post already!

Got up a little more confident on my 2nd day, went in and got stuff ready for a registrar ward round. Morning went fairly well, had my first consultant ward round close to lunch, which didn't really count, as we only saw 5 patients.

1 of whom was pretty interesting; she was nice to talk to, and pretty healthy in herself, but was suspected to have a fairly ominous inflammation of the blood vessels.

Went for teaching late, we need to fill in forms to say that we can ask patients for consent. It seems as if our life will be filling in plenty of forms from now on.

Afternoon saw me getting interrupted with doing ward jobs by a relative of a patient who wanted me to see him because he was worried. Its a sad indication of how jaded I am that I was immediately thinking of how this would all be a case of reassuring the patient and his relatives that all was well, and that the worst thing that could happen was that I'd finish later than usual.

It turned out to be a suspicious sounding account of chest pain, that led to more and more tests and resulted in me handing the patient over to the house officer on call for nights. Just goes to show, I guess.

Friday was by comparison the most free day I'd had. Highlight was getting all my bloods and cannulas in without a hitch. And also that we chipped in to help one another finish on time (well, an hour later, but still...) and being able to head to the pub across the road for a well earned drink and a gabble about the 3 days of work.

'This feels like the first weekend I've earned in 4 years'

A good lie in tmrw...sounds just what I need:-)

Thanks for your prayers, and to the various people in UK starting their first week, well done for surviving!

Chronicles of a Confused Doctor 2

Woke up feeling nothing like wanting to start work. Bed was warm, it was raining outside, etc.

Arrived and was asked to prescribe morphine to a patient. Blur. Patient was left off it due to worries that it would suppress his respiration. Compromised by prescribing another painkiller and promised to come back.

Arrived in time to start a ward round with a ST doc who happened to be Malaysian. Both of us being new to the ward, the round took longer than usual, the most irritating thing being that my network password refused to work.

Finished nearly at 1pm, did a couple of blood gases, missed the first and wasn't too convinced by my 2nd attempt, but the machine read it, so wasn't too put out. Took off for 45mins and missed my 2nd ward round which I was convinced would start later.

Came in halfway, the consultant was pretty good about it. Had a ton of ward jobs to complete after that, mostly mundane stuff like drug prescriptions for pts to go home with.

Most exciting point of the day was being bleeped for a patient whose potassium levels had gone up for apparently no reason. Took and sent off a repeat blood test and promised I would review the ECG results. Was pretty certain that the Twaves looked higher especially when comparing to prev ECGs but the reg wasn't convinced.

When the results came back, the levels were even higher than what had been before. Technically I knew what to do, but wasn't convinced about writing stuff down, so had to bleep the reg and confirm treatment to bring potassium levels down. Found the hospital formulary to be a great help.

Drug round time came around, and because 3 of us house officers on the ward had been busy doing other jobs, and had not rewritten drug cards, the medicine round by the nurses ground to a halt while the 3 of us sat in a corner and frantically rewrote the cards.

Ended up going back a couple of hours later than usual. Chances are tmrw will be even more hectic.

To do:
- sort out network password
- Read up on pulmonary function test requesting and indications (what have i been doing for the last 5 years??)


-

Chronicles of a Confused Doctor 1

So tmrw is the day we'll be let loose on the wards.

Have decided to try to keep a day by day account of sorts, no telling how regular I'll be with the posts though.

Had a talk about our portfolios today; never realised how much there is to do apart from managing patients. Where we are going to find the time to do audits, present cases at rounds, write up papers I don't really know.

Weird: The night before, we went out to meet the doctors from whom we'd be taking over the wards from. Excused myself to the loo, where I proceeded to do number 1 to the strains of Star Wars: A New Hope. Seriously, who pipes in a movie to their toilets?

Anyway, more on the first day after it happens. And if anyone can spare a prayer for me, I'll be grateful:-)

The Eagle Has Landed

Now, at the end, only is it clear.

I am going to be a doctor, for real.

Accepting the fact took a while.

I'd still much rather :
- be more prepared
- have another week of lying in

But in the end, I;m still looking forward to Wednesday.

Induction week

'Whats that test you do for ppl you suspect have an MI? Some cardiac enzyme....not amylase...?'

'Yup, like that Ventouse family.' 'You mean Von Trapp family?'

'What would you like to do for this patient?'................'I'd like to investigate him.'

'Hi, I'm Jonathan. Oh, you're doing medicine too? Brilliant! Er, are you up for swopping on calls?'


And meeting a whole group of people whom I've never met before, there must be at least 60 of us Foundation Year 1 doctors starting in the Royal Liverpool University Hospital this August, a period of time known as the F1 phenomenon, where patient admissions drop, and mortality rates go up. Fun fun fun.

AT least I'm not on call first week.

Just wondering

With the start of work, comes responsibility, trepidation, and the slight regret of not being able to sleep til 10am every morning.

WII is fun to play, but for some reason I'm not very good at it. Don't think I'd like one for myself though - still prefer PC.

The Dark Knight was as good as the reviews painted it. Heath Ledger was unpredictably scary as the Joker, and while the last 45 mins went by too fast to really make sense to me, it was thrilling enough not to matter.

Prince Caspian was not as good for me, simply because of how much it deviated from the book. Having said that, it did keep me entertained for the duration, and was definitely more action-packed and climactic than the first one.

Whenever I hear a line in a movie that echoes the book word-for-word, shivers run up my spine. I think that's because those are the books I wanted the most to be brought to life. And that what I'm seeing onscreen will from that point on BE what I imagine the book to look like.

I need to pass my driver's license soon. GBP100 is way too much to throw away.

Madrid 08

The inside of the bull-ring
The botanical gardens

A long overdue post about our trip to Madrid in...sometime near Easter!

Ai Lee (also a doctor now) joined us from Msia, together with Jack and HP, the 4 of us set out to see the sights of Madrid with Lonely Planet as our guide. Besides Madrid, we explored the towns of Segovia (known for its castle, upon which the iconic Disneyland Sleepy Beauty castle was modeled) and Toledo (a old walled city apparently home to previous kings of Spain).

Above one of the castles in Segovia.

Countryside view from the castleAqueduct in Segovia built without cement

Madrid itself was ok. Like any other large city, it had a certain fammiliar feel. Its divided into various districts, and has many squares dotted around the city. If you've watched the film Vantage Point, you;d have seen one such square.

Plaza Mayor

The food was interesting in that we had tapas for nearly every meal (when we weren't having paella). They are small-ish dishes that accompany drinks, and range from baby eels to ham to blue cheese to roast pork. It didn't help that many of the places we went to seemed to have inhabitants that spoke mainly spanish, leaving us to guess at which dishes to order. Having sangria constantly kept us in a good mood however.

Museo de Jamon - Museum of Ham
Baby eels
Sangria with lots of fruits in
Bits of ham - they keep these for years at a time before serving
Cocido - a peasant sort of stew

The flamenco dancing and the bull-ring were interesting, but what kept us going back for a few nights was the churros con chocolate. Looking and tasting a lot like yau char kueh, you dipped it in chocolate that came piping hot in bowls and ate it before the crispyness disappeared. Nice stuff. Together with coffee ice -cream (thats ice cream with hot coffee poured over) which is served in every establishment including McD's, that kept us going throughout the day.

Where we had...
These bad boys ! Churros
Flamenco at Cardamomo
Las Ventas - the largest bull-ring in Spain

The rest of the time was spent wandering around gardens and parks, and avoiding unsavoury characters by pretending to be couples out on a holiday.

Our trip ended with us getting detained at Liverpool airport for fear we were terrorists, but other than that, the journey was uneventful. Barcelona seems to be a must-visit still.

I'm still alive

Really.

It doesn't get said often enough..

Thanks for the last 25 years, ma.
See you in June!

I think they call this a plug

Its been a busy week, but finally, Bank Holiday weekend is here!

While on my morning surfing rounds, I stopped by some blogs that I'd not visited in a while , and this is what I've found.

3 friends have started off their own company...behold...

TESTIFY WEAR !

Had a look at their site, I think its pretty cool, and that the reasoning behind it is pretty sound - I mean, clothing being a great platform for making a statement, not to mention that t-shirts are a staple in hot Malaysia.

Plus, these guys are a testament of taking what they believe in into the marketplace, and being another influence in the mainstream media.

Have a look, especially if you're back home:-)

Today was good

For myself, to start off the week, Isa 40:28-31 was a good reminder. Embodied in the form of the song 'Everlasting God' which we sang today, the lyrics speak for themselves.

Strength will rise as we wait upon the Lord....

The chorus is particularly uplifting:

You are the everlasting God
The everlasting God
You do not faint
You won't grow weary
You're the defender of the weak
You comfort those in need
You lift us up on wings like eagles.

Its a much-used passage, but it rings true time and again. Something to hold on to on busy nights on call, or while waking up to the prospect of another day at work.

Happy holidays

I've always said that one of the nicest feelings one can get is when you wake up and realise its the beginning of the holidays.

Having said that, its early, and we're off to Madrid for a much-awaited break.

Had a good dinner with Ai Lee and the rest in Philharmonic last night. From now on, its tapas all the way! With the odd churros y chocolate thrown in!

In the meantime, because its not likely to stay forever on my hard drive, here's a photo of Jack practising his endoscopy skillz.
Random is good.

Here's hoping Madrid's weather will be kind to us.

Lately

This is a nice big picture of the Mount of Olives. Where Jesus spent a lot of time with His Father.

Its relevant for a couple of reasons. I gave a talk to the youth in church on Sunday about 'Learning To Be A Leader' and this picture was involved. To those of you who answered my leadership survey questions, many thanks! A number of them responded to the call to increase their sphere of influence and to be open to leading in various areas in the future. All by God's grace of course, as the powerpoint kept failing on me, and my words were rough at the best of times.

The picture is also relevant as I'm considering getting a camera to replace my 3 year old Pentax Optio which was stolen last summer while I was back in Malaysia. I've been relying on my Samsung 2mp camera phone to provide quick shots, but lately I've realised I'm not as keen to take photos as before. Which may be a good thing, but it means less things remembered. So I'm considering a new digital compact.

If I had the cash, the Ixus 860IS would be great, but since I don't, I'm looking at the Panasonic Lumix FX-35 or FX-30. Both not top of the range or the newest, but they have enough megapixels (8 i think) to keep me happy, plus the draw of the 28mm lens for more panoramic shots is very tempting. Also looking at the Ricoh Caplio R7, which also has the above features, is cheap, but apparently is pretty noisy (and not talking picture noise here) in operation. All of the above can be had for around GBP150 which translates to about RM1k, and I realise its probably a lot cheaper in Msia, but hey, I can't be buying stuff and shipping them overseas forever.

Anyone with any experience of using the above cameras? Would be glad to hear from you and also from anyone with more suggestions of cameras around that price range.

Interesting...

Some new research has come to light recently...being a soon-to-be doctor, I heartily urge all interested people to read this article from the British Medical Journal.

Being slightly tech-conscious, I know a techie wonder when I see one. Anyone looking for a new laptop, consider this Airbook from Logitech.

WoW fans, check out this ad for the latest expansion!




An update to the Starcraft 2 new unit roster: the Tauren Marine!

Finally, if you're still interested, here's a link to the history behind it all...