Hello Ethiopia!

Now faith is the substance of things hoped for, the evidence of things unseen.
Heb 11:1

I often employ faith unknowingly in life - whether it is believing a patient will get better with augmentin duo forte when in fact I have no more detailed understanding of the underlying mechanisms than the knowledge that it is an antibiotic that can get into the cell wall of bacteria and inactivate its' functions (by some in-itself-near-mythical unknowable biochemical process).

However I often have no idea if the patient is indeed, harbouring that particular bacteria, or if he is, whether the bacteria is in fact, the cause of the patient's chest infection. And even if the bacteria is present, whether it is harbouring resistance to that particular medication.

Why is it, then, that a stepdown to augmentin is often taken after a few days' worth of intravenous antibiotics in hospital?

I believe it is because:
- we've seen it work before in other patients.
- we believe the doctors who taught us to do it in medical school/ward rounds know what they are doing.
- we are so used to prescribing it that we feel we know what we're doing (the common side effects ie liver function derangement, interstitial nephritis, clostridium difficile associated diarrhoea, resistance etc)


Isn't faith in God much the same?

We believe in God and His Son's resurrection work and the Holy Spirit in us because:
- we've seen Him work before in other people, and in ourselves.
- we believe the Bible and its' authority as the Word of God (2 Tim)

And the more we trust God, the more it feels almost natural to run to him - more natural to praise Him for the good, and rely in His guidance during the trials.


And no, I didn't prescribe augmentin to anyone today! But I'm trusting in God and His provision and guidance for Ethiopia Part 2!

3rd post in a day - record!

My car is a transformer!


If anyone still wants to get me a Christmas present....

Things I'm looking forward to 2

If you played computer games from the 1990s to early 2000 and enjoyed classics like Baldur's Gate, Planescape Torment, Jagged Alliance and Duke Nukem, chances are you'll have heard of GOG.com. If not, here's a good reason to check them out!

Southport Musical Fireworks Championship 2010

An enthusiastic Woei Lin with an even more enthusiastic Sasha

I had no idea this was on until Woei Lin my ex-housemate asked me if I was getting tickets. Apparently held annually, it's between a few ?fireworks companies who spend untold sums on getting fireworks timed to music.

Yes it rained

The whole thing kicked off at about 7pm with a demonstration of different types of firework(?s) eg what a Catherine wheel did as opposed to a Roman candle or a tourbillion. Being a fan of Paddington Bear, E.Nesbit's The Treasure Seekers etc, (all of whom described particularly memorable firework segments) it was actually pretty interesting.

No my camera doesn't do night shots well.

The main event turned out to be better than expected, particularly the first performance which was themed around Britain's Got Talent. Favourite bits below.

Travel?

So, no holidays to Korea anytime soon then.

For the gamers

Saw this a few days ago - and decided to let anyone who reads this page into the secret!

If you're a gamer, or have a netbook and are wondering what to do in your spare time on the train/bus/plane, have a stab at this!

Offer ends in 2 more days!

And on a totally different topic - this one is for those who are disillusioned by Christians.

Quickie

Interrupting the work to say:

There are 11,000 free eBooks up for download at The Book Depository, so have a look and pick up those you like, or those you haven't heard of before!

A+E, contrary to my facebook, isn't that bad. So far..

It's Been Ages

and I've not got much to say:-)

Suffice to say I've been on a busy set of nights, am girding up my loins (still no idea why and how that phrase came into use) for MRCP Part 1 (wish me luck, and more importantly , keep me in prayer!), planning for my trip back home and Down South, all the while wondering what God's plans are for the next few months, especially after June next year.

I suppose the only other thing is that XBox with Jack and Woei Lin has brought back fond memories of playing on the Amiga when I was in primary school. Back then my cousin would come over every so often on a weekend (he's a medic now as well...whats the world coming to) and we'd take turns playing the games my far-sighted dad bought (presumably for our entertainment since he never played himself) - Double Dragon was one game I remember playing together with him.

Not much has changed, except the graphics haha! Gears of War 2 looks brilliant on our new 32 inch TV, another perk we allowed ourselves this year as 2nd year doctors:-)

Am loving most of the songs on Imogen Heap's new album!

Up is definitely the BEST Pixar film ever to date, eclipsing Wall-E any day.

Better pop to bed, music practice tmrw morning for Sunday. And then a baby dedication after that. Everyone seems to either be getting married or having baies nowadays:-)

Liverpool Food Festival

Well its actually mainly about my comeback to the baking scene, after years (literally!) of failed trifles, bread-and-butter pudding and crumbles, I finally managed to bake something that people finished eating! hooray for me!

They say the proof of the pudding is in the eating...well, I'm just happy it looked like how a cake should look.
It was chocolate fudge cake (apparently), the original recipe is taken wholesale from my cousin's blog, somewhere I go to to dream about good eating now and again.

Also had a pretty good dinner at 60 Hope Street, somewhere I'd never be able to afford normally as mains go for about mid-20's, however as this week was the Liverpool Food Festival, they had a pretty good deal going on their website (its running till the 26th of Sept so any Liverpudlians want in, head to their site!)


3 courses for GBP18.95 plus a bottle of Rose for 2, sounded like a pretty fair deal, so 5 of us went to try it out. Esther and her sister, Naomi are good foodie people, and Asyikin (an M202!) and Frank made up the party.

Spent a good while discussing what these berries were, and found that the staff didn't know either!

I think my order of starter (Cumbrian ham tart), mains (fillet of Goosnargh chicken) and sweet (Ms Kirkham's cheese with beetroot cake) was probably the weakest of the combinations available - Esther's hake main dish, with Asykin's smoked salmon starter and the mousse dessert were pretty strong options. Even so, the meal was probably one of the best I've had out in Liverpool in terms of English dining. Can't remember much about the wine except that it was Spanish, and there was a lot of it - slept well that night!


Then come Sunday, it was the end of the Food Festival, culminating in a Farmer's Market all along Hope Street. Something like a pasar malam back home, a farmer's market is how UK farmers have a chance to sell directly to the customer, thereby cutting out the middle man and resulting in a higher profit margin.

Looking pretty bare in the morning before it gets crowded later.

I'd planned to meet up with Esther and her cronies from church so heading there after Sunday Service, I found myself confronted with the above scene. Felt hungry so settled for a roll with Gloucester Old Spot hog roast with the stuffing and apple sauce at the shop below.

Let's just say I wasn't blown away. However things looked up as I'd heard there was going to be free performances by the Liverpool Philharmonic Orchestra with their resident conductor in charge. Ducking into the Philharmonic, I managed to steal a seat in a box after convincing an elderly couple, that no, I wasn't going to to shout or take tons of photos midway through the performance:-)

Beethoven's 5th Symphony (according to Pa), Haydn's Symphony No. 100 and Beethoven's The Creatures of Prometheus ballet was my introduction to live orchestral music, and it was good.

Tried biltong, which I'd read about in King Solomon's Mines and always wondered what it'd taste like. In real life, its a strip of jerky-like meat studded with seeds (fennel?) and is really really difficult to bite through. According to Esther (who should know since she spent part of her life in Africa), they're meant to be chewed and chewed and chewed. Not exactly sharing material:-)

Total haul for the day: clockwise from top left-

Smoked kippers, which I'm assured will taste absolutely brilliant boiled in their bags and then dropped on top of white bread.

Cain's Raisin Beer, which as a flavoured beer, I don't get to try too often.

A French artisanal loaf, which apparently uses French flour (I obviously have no clue) and therefore is tastier.

Some sweetcorn lobbed into my bag by Esther.

A pot of homemade damson jam - was looking for quince jelly but no one stocked it.

A chocolate tarte and a slice of chocolate ganache cake.

Two venison tarts with orange and juniper toppings.

YUM!

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!!

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?

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!

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.

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.

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.

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..

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.

**

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.