Sunday, December 25, 2011

Hymn and carols

Merry Christmas


The spirit of Christmas fills the world - restaurants, shopping centres. almost all public areas have a hymn or a carol playing in the background to create the ambience for the festival. Choirs and small groups perform in hospitals, community centres and homes for the enjoyment of the less privileged. The music that fills the air is indeed one that brings people to a joyous mood.

It is easy to sing along to the tune and go with the flow of the Christmas mood. What few think about really, is the actual lyrics of the songs. All hymns and carols did not originate purely from a composer's mind. Every sentence, every word is filled with praise to Jesus; the beauty and glory of God which inspires the songs of praise.

Let's take one of these carols as an example

O Sing, choirs of angels,
Sing in exaltation,
Sing all that hear in heaven God's holy word.
Give to our Father glory in the Highest;
O come, let us adore Him,
O come, let us adore Him,
O come, let us adore Him,
Christ the Lord.

A verse that simply runs through the minds and the lips of carolers as they sing without much thought to anything but the enunciation and the melody. But if one examines the meaning behind these words, how powerful and how meaningful it really is!

O sing, choirs of angels, sing in exaltation! The carols aren't meant purely for our own enjoyment, it is meant to exalt God in heaven above! Exalt his Name, exalt His Word, that all may hear His holy Word. Give Him glory while singing, exalt the King in these songs! Come, let us adore Him, adore Christ the LORD for He is the reason for Christmas. He is the one whom we are praising and worshiping whilst singing these carols.

This Christmas, let us sing these hymns and sing these carols, not because they sound nice, or because others are singing it too. Sing it because this season is Christmas, and commemorates the birth of Christ, our King, our Saviour, our Redeemer...

Merry Christmas everybody

Saturday, November 5, 2011

Love

Love - a very simple word with a very complex meaning behind it. Who can fully comprehend the power of love and its impact on people?


There was this 3 month old baby suffering from chronic lung disease, swallowing difficulties and respiratory distress. Everyday, she would be fed through the NG tube; she needed oxygen to support to survive. Everyday, she only sleeps, and occasionally wakes up for minutes before sleeping again, without noting anything around her. Still, her mother would always be there, daily. She would be there by the cot-side just looking at her daughter, ready to attend to her whenever she makes the smallest cry. One day, when the baby was ready to go home, her mum could only grin from ear to ear with a tear of joy in her eye.

This 10 year old girl was diagnosed with type 1 diabetes mellitus. As students, we just went through the motion of asking about her dad about her condition, her signs and symptoms with all the other typical questions. Halfway through the conversation, daddy's eyes notably turned red, his speech started to tremble a little, as he forced out the words: she'll need to take her medicine for the rest of her life...

A 9 year old girl had a rare metabolic disorder. She was not born normal and she would never be normal. While she sat in the bed playing with picture cards, her dad simply sat at the side, looking at her lovingly, smiling whenever his daughter handed him two cards to piece together, picking up the dropped cards without the slightest complain even though this happens non-stop for hours. Her life depended on enzyme replacement therapy every 2 weeks each costing a hefty SGD1500 after subsidy. He told us, "Well, our family simply lives from day to day. Actually, last time the doctor said she would only live up to 5 years old." You could feel within him, that he had mixed feelings of joy and hurt.

This young kid was admitted to the hospital and stayed in the wards for almost a month before he went home. During his stay, he was hyperactive - running around the whole ward, being the big brother to the other kids, finding friends, playing happily. Nobody would guess that he was a victim of child abuse. The day he was discharged, he called out to me (at the bus stop) - my first reflex was to ask, "Wa, going home already ah?" The reply came back rather drearily, "ya..." His eyes were downcast, he evidently preferred to stay in the hospital than at home where he could find ... if i dare say... more love than in the past...

Stories like these aren't uncommon. There are parents who love their children so dearly and rejoice in their recovery. Others are forced to accept the harsh reality that face their children. Still, others do not treasure what they have, and bring sorrow to self and others around them.

Wouldn't it be great if every family is bonded purely by love, love that is modeled upon perfection - patient, kind, does not envy, does not boast, is not proud; does not dishonour others, not self-seeking, not easily angered, keeps no record of wrongs; doesn't delight in evil but rejoices with the truth; love that always protects, always trusts, always hopes, always perseveres; love that never fails...

Love is so powerful in so many ways. The presence or absence of it can make or break a person. It can build relationships or destroy them. It can make a family everything... or nothing...

"And now these three remain: faith, hope and love. But the greatest of these is love" - 1 Corinthians 13:13

Show me how to love like You have loved me

Sunday, October 2, 2011

Returning to the throne of grace

"Our church has people with many problems, but we are God's people"

I keep wondering to myself: how many times must we fall from the same mistake before we learn from it? It's always upon looking back after falling where we realise where our mistake lies. We try to learn from it, but for some reason, the lesson doesn't last.

There is just this one thing I need to learn: The pursuit of anything but God almost always translates to misery and dismay. Things don't always turn out how we want them to. At one point, when we expect something and the opposite happens, things just fold in onto us; we're affected greatly, we wonder what or why things went wrong?

This morning, I was half thinking about not going to church~ but I'm so so glad that I went in the end. I realised that in times of failure and brokenness, instead of running and hiding from God, I should seek Him and renew myself in His presence. It was particularly great to see Dr Tan Lai Yong as the speaker today in church - he's always been one figure who's been particularly inspiring to me even though I've heard little about and from him.

God worked within me in wonderful ways at church today. The worship songs appeared to be tailored to my needs. The message was directed to the problem I was experiencing. Although church took the same amount of time today as the past weeks, it felt to me that it was over ... just so fast today.

I just pray that, this encounter I've gone through will once again act as a reminder that God is central; no benefit will come if I prioritize anyone above Him - Him who is greater than all else, Him who I will ultimately bow before at the throne of grace

~~~

Now You are exalted to the highest place
King of the heavens, where one day I'll bow
But for now, I marvel at Your saving grace
And I'm full of praise once again
I'm full of praise once again

And once again I look upon the cross where You died
I'm humbled by Your mercy and I'm broken inside
Once again I thank You, once again I pour out my life

Sunday, September 25, 2011

Faith vs. Reality

If you have faith like a mustard seed, and you tell this mountain to move, it will move.

Went to church today with a heavy heart.

We're always told that when we're in church, worshipping, we should be leaving our baggages and burdens behind, focus our hearts and minds on God. But it's just so hard when your mind is simply elsewhere, thinking about other stuff, concerned about other matters. On another note, it's also so easy to tell others to have faith, to depend on God, to make time for Him and trust that He will multiply your time. But really, how many of us can actually practice that in the face of so many troubles? If I myself am unable to practice it, who am I to preach it others?

Just yesterday, during QT, I was meditating upon prayer and faith. The bible tells of many stories of which men of faith have prayed fervently and God is moved by their prayer and grants them their request. Testimonies from brothers and sisters in Christ also speak of the power of prayer with faith. Then I looked back on myself. How much faith do I actually have? It's a constant struggle indeed.

I only had one simple request yesterday... And when I put reality and nothing else into perspective, I knew that request was never gonna happen. But I knew that if I asked in faith, without doubt, what I ask would have been fulfilled as I'm sure my request would be in line with God's desires. Unfortunately, I knew without doubt... that I had doubts. It's so difficult sometimes, just to pray... in faith. Without doubt.

In the end, I didn't dare think too much. Intellectualism in the kingdom of God almost certainly fails each time. I didn't dare think about the outcome. I just prayed. I'm really not sure how much faith I had at that point. I just asked.

Father, may Your hand and Your grace be upon those who need it.

Saturday, September 3, 2011

Romance, reality and repulsion

Activaid 2011 was a nice insight of how mission work overseas is really like. It was no longer things like: you should go for missions; the people need your help; why providing aid to neighbouring countries is important; the need in the world. No, the speakers there knew one thing: they want to go on missions, and they have been. No more pep talk on pushing people for missions. The conference was on missions, and how they are realistically. What do you want to achieve? How is it going to be done? What are the short term and long term aims? How is finance going to be settled? Very real questions to very real problems.


The second workshop I attended was termed: Avoiding another 'hit and run accident'. There are instances when people go there with good intentions, do a job halfway and leave. Not only do they not help the people, they left an obstacle: a half built and useless concrete buildi... ruin in the middle of their village. So, yea the talk was how to avoid that or the like

One thing the speaker brought up was the progression of how people who want to go on missions go down the route of romance, reality and finally repulsion.

Romance: Yes, missions are really great! I want to go out and help others, to reach out to those who need my help, to hear the marginalised society and give aid in every way possible. I want to build houses for them to live in, toilets for good sanitation and help them find a stable income to break the poverty cycle!

Reality: Well, I can give this family a meal today, but that helps them for one day. They're hungry again tomorrow. The new system implemented for better sanitation is not being accepted by the villagers due to custom and habit. There aren't enough funds to do what I want to. I cannot stay here forever

Repulsion: Missions are stupid. They're absolutely useless. They waste time and they waste resources. All this effort put in will only come to zilch. I'm never going for missions anymore. I'm going to discourage everyone from doing it.

Sounds harsh, but definitely true in some situations. Not only in missions I would say, but also in the wards, in the calling to do Medicine.

On my side, the 'romance' part started very similarly. The passion for learning, for helping others, to heal them, to cure them, to better their lives. Nothing detered me, not even the doctors' advices which all ranged from: bad choice; 36 hour shifts; *shakes head*

'Reality' has set in. Studying isn't easy. Well to be fair I never loved studying. But still, the field of Medicine is just so big. There's so much to know and probing too much into one area leads to a deficiency in another area. It's just not possible to cover everything however hard one may try. But that's only secondary. Learning is a lifelong thing. Even the consultants are learning. Studying is important, but what about our morals, and this big thing about ethics?

The other day in one of the ward rounds, an MO was asking a consultant regarding medical futility versus the law. The discussion went on to talk about negligence, and quoting the consultant...

"There was this case about a guy who went to the doctor for an acute chest pain. The doctor did an ECG, found it was very fuzzy and could not read much from it and decided that the ECG is normal - he discharged the patient and tore up the ECG because it was of no use. The very same day, the patient died due to an AMI. The doctor got stripped of his license, not because he failed to pick up the AMI, but because he tore up the ECG - he had no prove he did an ECG for the patient. If he did not tear up the ECG, the court would have let him go.

You see, there is a difference between negligence and stupidity. If you do not do an ECG for that patient, you are negligent, your title deserves to be stripped. However, if you did an ECG, and the ECG shows a blatant ST elevation in a few leads but you discharge the patient saying there is a no problem, the court cannot charge you. They will just say, doctor, you can't read ECGs. You need more training. They cannot strip you of your title just because you are stupid. They can only do so if you're negligent"

The entire conversation.... I can't find words to describe my reaction. Shocked wouldn't be too accurate. Enlightened isn't right either. I felt like.... although I wanted to judge that consultant, I couldn't. He was very right because that's how the law is. But at the same time, how can a patient's life be lost simply because a doctor is "stupid" but not "negligent"?

Which brings back the thing about reality. Reality is such that nothing is ideal, nothing always goes as planned. Being skilled for the exams is one thing, being skilled in the important areas of service is another.

The scariest part of reality is, the possibility of it progressing to repulsion. I don't want to reach the point where I find the wards repulsive, find studying useless and worst still, find patients irritating.

Romance, reality, repulsion. Out of these, I'm supposing reality is the most applicable because, well, it's reality. What's most important is, integrating romance into reality and shunning repulsion from day to day. That's the ideal, but it definitely is by no means easy. Not with the environment around being so stressful and demanding in one way or another.

God, be my Guide. Be my everlasting Guide I pray.

Friday, July 29, 2011

I love you - sincerely, Jesus

Today was a great day because of how it ended - a meetup with CF comm 07-08 to celebrate Liz's birthday and a farewell for dear Skyler... A night of laughter and chatter over a buffet: what an amazing way to break the monotony of school :) Best part is, aunty Ros even joined us for dinner and treated us to yoghurt after that hahaha thanks aunty Ros =) =) It seems that the longer we move away from JC, the longer the intervals are for when we are able to meet up as a comm to catch up with one another. Thankfully, little has changed, not our character, not our maturity (lol), not even our valued friendship and hopefully, not our devotion to God either. Being in the company of them definitely is an outlet of stress, thanks CF comm, and take care Skyler!!

Well, the highlight of this post really, is about my trip home given by aunty Ros (many thanks for more than just the car ride :)). Most people are relieved of their stress and worries by pouring it out to the other party. Aunty Ros on the other hand, was able to minister to me just by speaking on and on about seemingly random things. Somehow, these random things were so relevant to the problems and struggles I was currently facing tonight - as if God was using aunty Ros to attend to my needs at such a perfect moment... I've always been amazed about how Godly she is and how God speaks to and through her so clearly every single day...

"... I'm not really a person who knows songs very well, but these words came to my mind one day: I am forever in your life, I'll see you through the seasons... and these words repeated another two times; I began to cry. I asked God, why is it that You are willing to follow me through my whole life? ..."

"... I asked her and found out these words actually came from a song which went: You are forever in my life, You see me through the seasons. But the words that I heard, they came from God, it went I am forever in your life - it was God speaking to me..."

"... then I realised, God is telling me one very simple thing. He keeps telling me, I love you, I love you, I love you..."

My past two posts were just part of my many many thoughts running through my mind in the past few days or maybe weeks. Well, human nature tends to get me analyzing here and there... I attempt to find solutions, explanations or whatever else for the things I face. Sometimes it works, most of the time it leads to more thoughts, more troubles - mostly self inflicted. Going to church, praying more - all seemed to be the right thing to do when doubts arise, but ultimately there just seemed to be this thing within me that wasn't too right.

Tonight I found the answer. I've been looking at so many things and missing the most salient point - I've forgotten that Jesus is repeatedly telling me: I love you, I love you, I love you.

What joy, what comfort all that brings. To just know that the Ruler of the Universe loves me. His unfailing love, the Agape love. Love that surpasses all logic and overcomes all barriers.

God works in strange ways. Sometimes He babysits us through, sometimes he puts us through trials. But ultimately, we know that through all this, He is forever in our life, He'll see us through the seasons, because He loves us. He loves us so dearly. And when these trials have passed, we come out better and stronger. What more can we ask for?

Thank You Father, for the CF comm, for aunty Ros, for the people around me, for the trials You've put me through and above all, for Your unfailing love

Monday, July 25, 2011

Compassion fatigue

Compassion fatigue (also known as a secondary traumatic stress disorder) is a condition characterised by a gradual lessening of compassion over time. It is common among trauma victims and individuals that work directly with trauma victims. It was first diagnosed in nurses in the 1950s. Sufferers can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self doubt - Wikipedia

Today in clinics, one patient came in and spoke these few words that woke me up from my half dazed state "... It's about time I start becoming selfish and think about myself"

She was a teacher in some primary school who had a progressive case of back pain, so much so that now, she is sometimes unable to even walk properly - needless to say, it affects her work. Her work entailed more than just teaching in the primary school. She held a motherly figure amongst the students, acting as a counseller for them, being there for them in all situations, regardless of school or non-school related incidents e.g. she was there for a student who's dad passed away - there for him to cry out because that student didn't want to cry in front of his real mum for fear of worrying or further upsetting her...

And right then, while she was sitting with a terrible pain in her back, her concerns weren't so much focussed on her terrible pain but rather they were on people around her: her family and her job.. or more accurately, her students. The doctor spoke of what was called "compassion fatigue". About how taking up roles such as counselling makes us feel good when we counsel the first or the second person. But what about the 20th person, the 200th person? Can we go on forever counselling these people without us ourselves being affected one way or another?

Today, the doctor ended his clinic past 7pm. Not so much because he had too many patients, but rather because he (very willingly) spent so much time with each and every patient, addressing their concerns and expectations and even going on to talk about their daily lives. I heard from his Medical Officer that he sometimes ends past 9pm. Surely he himself has been or one day would be a victim of this 'compassion fatigue'?

But the thing is, he definitely doesn't seem to be hit by this problem. If going home everyday around 7-9pm is part of his routine, while other doctors are going home before 5pm, surely there is this something that's keeping him going, something that drives him forward to maintain this compassion without being fatigued...

It so happened that this very night, I met my aunt in the wards who was extremely concerned about her mother in law, who was just warded. She was so worried that she even asked me for a "second opinion" about her condition. After a period of (attempting to) giving advice and reassurance, she was so grateful and so relieved just to have me around, explaining things to her - and that's even when she knows that I'm coming from a position that is far from a qualified doctor, and even possibly a misinformed person.

The rewards of this job is definitely great, fulfilling and immesurable to say that very least. But then again, there comes the balance between self and others. While this profession calls for a selfless person, is it really possible to uphold this position when fatigue simply sets in?

~~~Just another one of my random thoughts~~~

On a side note: My aunt ended with: I wouldn't really call myself a Christian, but this time I'm really praying to Him, hoping that He will see her through....

Talk about inspiration

Tuesday, July 19, 2011

Back in the comfort of God's Hand

The Godhead, Three in One and One in Three
Fully God and fully Man
Omnipresent and omnipotent
How can man fully understand Your Power and Your glory

The past month of clinicals have been rather easy going, but ironically, at the same time, just plain tiring. Add on the 1 week trip to Hong Kong + needing to catch up (without knowing what to), it was seriously exhausting to say the very least...

After a 1 month hiatus of going to Church, I finally went back last Sunday to the House of God. The feeling of familiarity, comfort and joy simply swept over me once again. I came to realise that the past month of exhaustion was largely due to spiritual emptiness within me, one that couldn't be fulfilled with leisure or rest. Once again, I was reminded of the importance of Christ in one's life and the centrality of Christ in all that we do.

This week in SGH wouldn't have been very different from TTSH if not for the fact that I've relived the joy of resting in God, finding renewal of strength and energy from Him. The smallest things could bring me a cheerful smile, while the toughest things wouldn't bring me down. Not forgetting, He has also blessed me with so many special moments repeatedly and that will definitely keep me going, however tired I may get. Once again, I've begun to recognize and count my blessings around me, giving thanks to Him who is faithful and giving Him the glory that is due.

"If I see, I will believe"
"Believe, and you will see"

Monday, June 13, 2011

Start of year 3

I recall that a few of my posts made when holidays end are always along the lines of: darn, school is starting, I want more holidays T_T

Well ok.. that still holds true hahaha but one thing I'm really thankful for these hols is that it has been one of my most fulfilling holidays in uni thus far. I managed to catch up with friends from JC and BB while going on trips/outings with uni friends. Time may have flown past, but the time that flew past brought precious memories that will stay. Indeed, God is faithful and blesses infinitely according to His grace. Those kairos moments that I posted about once or twice - I definitely had them. Those moments, however short, were immeasurably special to me and I believe they will be the times I look back on to laugh and smile in times of distress next time.

Well, the post has been rather rushed, coz it's 1am right now, I'm really sleepy and school is starting in <7 hours hahaha but just wanted to make a post before school starts, so here it is! Ok, off to bed for a much needed sleep...

Sunday, May 29, 2011

Faith that is more precious than gold

During the short attachment back at SGH, I met/talked to another few patients. Many of them left me feeling encouraged, left me feeling inspired. But none of them touched me as deeply as one elderly patient, Mdm L.

When I first met her, my very first impression of her was that, she wouldn't hesitate to declare her faith in God, neither would she hesitate to proclaim the gospel and its power. Her clinical condition then, was that she was feeling very breathless, and had to undergo an operation (which was to be done under local anaesthesia) in a non-conventional way which may pose more risks. A few exchanges went something like this...

Doctor: Mdm L, considering how there may be ______ risks, do you still want me to go ahead with the procedure?
Mdm L: Jesus will grant you the wisdom to do it well, go ahead!
~
Doctor: Mdm L, we're almost done. You are very brave! (FYI, even to me, an observer, the operation was so painful just watching it)
Mdm L: God has given me the strength to go through this :)

After the operation, we stayed back to chat with her for a while. Usually patients would talk about their concerns, about their experience so far in the hospital. But this lady here, everything she talked about would be centered around God, God and God. Indeed, she left an impression that would last.

3 days later, when we went back to chat with her, to see how she's doing, it was quite saddening to know that her breathlessness had recurred. Once again, she spoke of God. She spoke of how she has gone out to preach His Word. And how because of that, some of her closest ones have rejected her, and how others have come to know the saving grace of Christ. This time, the one thing that struck me hard was how she recalled God speaking to her 1 year ago saying, "One day, you will die of breathlessness". At that time, she was very confused. She was perfectly well and suddenly, God tells her she'll die of breathlessness one day.

Her current condition: it seemed that the operation 3 days ago only served to alleviate the symptoms without treating the cause (which was under investigation). Mdm L was getting very skeptical about medical science, but while that was so, her faith in God remained as firm as ever. She was crying out to Him, asking Him to bring her home, asking Him to shorten her suffering. She seemed pretty sure that this time, the doctors wouldn't be able to help for the one reason that God is probably calling her home to reward her for her works.

Mdm L told us, "The devil keeps telling me, see, you are suffering so much and God is ignoring you! Just jump down the building now and end your suffering! But God is telling me, you are My daughter and I will bring you home in a few months" She asked us: "Can I ask you? How many months is a few months? Could you tell me? I don't want to feel this way anymore. I want God to bring me home now"

She asked us to pray for her, to pray for God to take her away as soon as possible. Every moment spent talking to Mdm L was heartwrenching. It was so evident that she yearns to see God so much. She yearns for God to bring her to heaven that very moment. Her desire to see God was so overwhelming. At the same time, she was feeling so breathless and in so much pain. One part of me wanted so much to pray for her at that very point in time, to pray with her... But another part of me wondered so greatly, about how I could possibly pray for her, when her prayers would clearly be so much more fervent and so much more broken than my prayers would be.

Mdm L is truly by far, the patient who has touched my heart the most. A patient who has shown me a faith that is so strong and so pure; a love for God that grows with each day, to hunger for Him incessently regardless of her present suffering. Oh LORD, may You see her faith and love for You and honour it...

Friday, April 22, 2011

Post CSFC

Well sort of. I'm not sure if the exam is counted as part of CSFC...

That being said, exams start in 30 hours time and I have totally no idea how stressed I'm supposed to be. I came out with this theory that, based on the marking scheme, the minimum mark I need to get in order to pass is 25% of the maximum possible mark.

Sounds really easy, but I suppose human nature gets the better of us: we tend to think of the worst case scenario, how we would have to take a re if we fail, and how if we fail the re, we re the whole year and how if we fail the re-year we get kicked out. Yes it just seems to happen all the time for some reason. But practically speaking, that aside, I suppose I STILL want to do well for the exam, not so much because it's a judge of how well I've been studying, but rather because it serves as a marker as to how well I'm getting the hang of my future career ahead.

Anyway, exams aside (they tend to be depressing all the time... somehow...), it's only been a month in the wards and I've seen.. just so much. There are many extremes of the kinds of patients I've seen. There are patients who are cheerful regardless of their (severe) condition; patients who tend to think the worst of their (insignificant) condition; patients who are depressed; patients who bring joy to others; patients who are paralysed; patients who are healthy at the age of 80+ years; the list goes on and on and on...

I've come to realise that, one day, however good I become at taking a history or doing a physical examination, it takes so much more skill and experience to learn and know how to communicate effectively with the various kinds of patients, those with different outlooks of life, those with entirely different personalities. How do you educate a person who thinks smoking is beneficial for him? How do you solve problems within a family, beyond a patient's medical problem? How do you encourage a person who is terminally depressed? How do you continue asking for details from a person who knows he has cancer which gives him only a few more months to live? How do you communicate with a patient who has had a stroke affecting his speech, but is evidently gesturing for... something? How do you deal with.. death?

At first glance, while all these may seem so melancholic, it still brings so much anticipation of the future at the same time. We weren't (at least I wasn't) born knowing how to deal with all these situations but, God being my Guide, I'll pick these skills up slowly. Of course, in life there's always this thing that sets you back no matter how hard you try. For me... well, I guess Chinese always gets the better of me. But THAT aside, I pray that God will continue to enlighten me and nurture me into the person He has called me to be.

~Over every thought, Over every word, May my life reflect the beauty of my LORD~

Wednesday, April 13, 2011

Mid CSFC

I realise it's only 10 days to my CSFC exam and I haven't read even 10% of what I'm supposed to have to. Ok but that's besides the point for this post...

Since my last post, I haven't really had any new conclusion, it's still: hospitals are fun, but seriously physically draining. Somehow I feel that my current Med posting is more tiring than the Surg posting even though it's less packed to some extent.. It's more structured too but that also means more tutorials, and poorer quality time spent with patients.

Today I experienced part of what the seniors were talking about: medical students tend to "pounce" on patients the moment they have "good signs". I saw a patient today, led by the doctor in charge of my group, who had pretty severe ascites. Reluctant as she seemed to be, she was sort of oblidged to allow us to examine her as she was once treated by the doctor before. Didn't have much choice then since the doctor told us to proceed... Then there another patient with a goitre - rather rare sight in Singapore nowadays. She was really nice, being perfectly fine with random (and many) medical students examining her neck one after another. That being said, I can imagine how many "visitors" she'll have if this news spreads.

It seems like in the wards, it's always two sides of the same coin when it comes to medical students and patients. From the "practical" viewpoint, spending time with patients benefits them more as they get to express their heartfelt thoughts, while for the student, it'll mean that he gets to see less cases. "Good signs" are definitely good for the learning of a medical student, but on the extreme opposite, that probably means that the patient has a rather severe condition, so much so that he now exhibits the "good signs" that we are expected to pick up.

The list goes on. A chop-chop attitude is considered efficient for students but leave patients feeling they've been "used". Talking to patients whom we clerked in the past makes them happy, but on the contrary it's considered "a waste of time" on the students' side. NOT "spreading the news" of a patient with "good signs" would be considered selfish to students, but a great favour for the particular patient - they sure don't need the exponential growth in "visitors"

Notice the extensive use of apostrophes so far. It's not to say that these words within the apostrophes aren't meant literally. They are. It's just that, there is so much more meaning that is left out in those words. Wasting time isn't the smartest thing to do when your exams are coming, neither is not approaching patients with good signs very wise if learning is to be possible. But is talking to patients really a waste of time? Is it right to bother a patient just because he has good signs (considering group after group of medical students have approached them already)?

The balance has to be made, between learning and patient welfare. But as of now, I believe that patient welfare is top priority. God won't fault me for not learning everything; the world of medicine is endless anyway. But I believe it isn't right to learn at the expense of the patient's wishes.

Just another random reflection from CSFC~~

Saturday, April 2, 2011

Reflections from CSFC week 1

It's been a really tiring week, mostly self-inflicted I would say. But I suppose at the end of this week, I've seen much more than I have over the past 2 years, and learnt much more than I would have over the course of 10 PBP sessions. Practical really puts more perspective and more purpose than dry text. I gave some thought about the past week though... and so I've reached the conclusion that...

Awesome as it has been, it has also been a tad depressing... somewhat. I'll use three patients that I clerked as examples...

I clerked Mr A. on Tuesday. One of the standard cases - obstructive jaundice. Went back to see him on Weds, his pain and cough was gone, he was feeling better. Then I went back today to see him again, found out he had diarrhea, with the case notes suggesting sepsis and hepatic encephalopathy

I saw Mr B. for the first time on Thursday. An elderly man, with children who wouldn't support him. Monthly income of <$1000; government rejected his multiple applications for a HDB flat.

Ms C. had SLE. She was really cheerful, really helpful. I was probably the countless medical student who approached her to ask for a history. One question and the entire history came out, filled with medical terms and information that taught us much. On that day, she was awaiting results - which came out the following day. Her previously controlled condition had progressed to cerebral lupus. A very poor prognosis indeed

I think about such cases and then I think back on my goal of striving to be a doctor. Much as medical science can do, it cannot solve chronic conditions, it cannot solve end stage diseases and all the more, it cannot solve social problems.

People talk about how great doctors are, how they have the 'ability' to heal and how they are able to change lives. But really, what can doctors do for these things? Nothing I would say. Simply nothing. While all these glorious talk is going on, what people don't talk about is how helpless the healthcare profession is when faced with these problems. Paliative care doesn't heal, it relieves. Financial aid has its flaws, as evident from the elderly man's case. Medical science right now tells you that you have a chronic/end-stage disease and it leaves you there - no cure.

So what really is the purpose of health care workers? With much thought, the best answer I can find is that, we treat those that we can. For those whom we can't, we'll have to support them emotionally, if possible, financially. Thing is, there's always a limit. How much time can you actually spend with one patient when there are hundreds and thousands more out there who need someone to speak to, but don't? How much aid can we give to one person, how much do we help each one of them?

I think back to the story of a boy and the beach of starfishes...

~~~
Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out "Good morning! May I ask what it is that you are doing?"

The young man paused, looked up, and replied "Throwing starfish into the ocean."

"I must ask, then, why are you throwing starfish into the ocean?" asked the somewhat startled wise man.

To this, the young man replied, "The sun is up and the tide is going out. If I don't throw them in, they'll die."

Upon hearing this, the wise man commented, "But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can't possibly make a difference!"

At this, the young man bent down, picked up yet another starfish, and threw it into
the ocean. As it met the water, he said, "It made a difference for that one."
~~~


I suppose, that'll be a good way to end this post. It's a long journey ahead. And it'll a journey guided by God. LORD, may You guide my steps, my speech and my heart.

Tuesday, March 29, 2011

CSFC

Day 2 of CSFC. Madness would be a good one word summary.

That being said, clinicals has been even better than I visualised it to be. The majority of the consensus I see about clinicals is that it kinda sucks - tiring and the like.

Personally, I feel that it's really a change from the standard lecture theatre setting, just sitting down, copying notes like a robot - information goes in from one ear, and comes out the other, only translating to words on distributed notes with nothing staying in the brain...

Although it's only been the second day, just these 2 days have shown me a totally different side of medicine. It's no longer as dead as before, being confined only to notes or at best, simulated patients. Being in the wards have shown me so much more, allowing me to empathise so much more with the patients, personally talking to them and examining them. Of course, I'm just one of those noobs knowing nothing. Difference is, I'm learning so much more and I believe that, over the course of the next few years, there'll be even more to learn, even more to discover and so much more room for improvement

Physically though, it's exhausting to say the very least. It's probably as tiring as the most tiring day I've had in school, just that it's happening/will be happening everyday. But I guess the important thing is, overall, I believe I'm enjoying myself much more now than I was in the past two years. Another big step in realising the joy of being in this profession. A calling indeed. One doctor today called it being self-righteous by saying it's a calling. I call it the perfect will of God.

Fatigue aside, I'm definitely looking forward to the future days, months and years ahead.

Monday, March 14, 2011

God and disasters

Much talk and much news have been going on about the earthquake in Japan, and the tsunamis that are arising because of it. Here in the comfort of my own home, I'm nowhere in the position to empathise with those in Japan who are suffering, those who are dying due to lack of shelter, lack of food and the bare essentials. Death toll over a thousand and many more to come due to poor sanitation, outbreaks of infection and more. And that's not even considering the social and economical impact in the long run...

All these have led me to think back once again on one of the many questions I asked in the past... Why does God allow natural disasters to happen?

I've been thinking and I've been reading and I can't find the answer. There are so many... just so many different "answers" out there including some of mine that may~ seem to answer these, but none of them really fit too well

If all things are for the glory of God... how does this glorify God?
If all things work for the good of those who love Him... how does this work out for the good of those who love Him?
The list goes on.

We ask so many questions like that, hoping to find an answer but at the end of the day, they serve to do nothing and may even stumble us... I'm reminded of this phrase that I read somewhere before: "Sometimes it's not so much about finding the right answers, but rather asking the right questions" The point here is, are we asking the right questions? Are we meant to know the answers to the above questions in this lifetime? Perhaps not. We may not understand the answer even if we were told the answer in our faces anyway. Afterall, in Isaiah 55:8-9 we are told, "For My thoughts are are not your thoughts, neither are your ways My ways, declares the LORD. As the heavens are higher than the earth , so are My ways higher than your ways, and My thoughts than your thoughts". We can only trust God and believe that He will make all things beautiful in His time...

Maybe the right question right now, and probably the more practical question right now would be, what can we do to help?

If even us, the creations of God are able to grieve for the people in Japan right now, people totally unrelated to us, people whom we don't know and never will, oh how many times more will God grieve for them? How many times more pain does His heart feel for them than we do? What can we do from over here? We can only pray. Brothers and sisters, let us pray for the people in Japan who are suffering right now. Let us pray for aid to reach them, pray for their safety, pray for their families. Let us pray with all our hearts...

Wednesday, March 9, 2011

Reminiscence

HAHAHA. I just went through my junk mail and received a notification from blogger that I had an old account which was about to be inactivated.. I went to the link only to find that probably 10 years ago I made a blog on battle on - another of those silly online RPGs. Went back to visit it and remembered that back then I wanted to make a game guide for that particular game on all the weapons spells armour etc in the game. Thinking back, I remember calculating something like I'll need say 10m gold to buy everything to test things out and was determined to do it... even though I took a few months just to farm 100k gold

Sigh~ memories from the past sometimes do evoke some laughter... Which actually reminded me that back then... I was so interested in gaming (much more so than now) that I aspired to be a computer game designer... I actually had a rough idea of an RPG... thinking of how I could make my very first game, upload it for people to get it free online and then grow from there. Then I started reading up on software programming and sorts, 99% of which was too complicated for an adolescent to understand. But one thing then was pretty sure: I had lofty dreams.. and more noticably so - I actually had time to do that nonsense.

Just a random thought: I wonder if God has ever called anybody into the gaming industry? Heh. That'll be rather interesting. Both from the perspective of the one being called and from how God would be able to work through that person in that particular industry

As for me, I know my calling. I'm rather content now with just playing games now and then when time allows rather than making them (especially since I've seen how you can never please even 80% of a player database with whatever you do). And definitely, I'm 100% content with where I am right now for I know this is where God has placed me. Coming back to the 'lofty dreams' part, being a doctor was yet another of my childhood ambitions... and I believe this passion was placed in me way before I even knew God for who He is.

Ok. Enough of the past. Back to the present. Exams are in 8 days and I'm nowhere near as stressed as I'm supposed to be even though I know I'll only be completing 1 round of study with no revision... Good or bad? I don't know. But I pray that once again, God will help me through this paper.

Tuesday, March 1, 2011

16 days to pros

First of all - Happy birthday AC =)

Just did a rough plan on how I'm going to cover my whole syllabus within the next 16 days; crap. I'm quite screwed heh. So much for taking it easy the past few days. On the brighter side, my studying pace has been picking up quite appreciably although not satisfactorily. It'll get better I believe... or I hope.

Averaging 10 hours of sleep a day. Now if only that could be translated into better productivity and better quality in studying.

Study~study~study - may seem like a mundane thing to me now, but if I could only just view it... as something required in future... to know what's happening in every patient before me... maybe that ought to be my motivation; rather than just studying to pass

Tuesday, February 22, 2011

So how does it all add up?

VCF today and dinner with couple of VCF seniors + batch mates yesterday. Put this two together and I got myself thinking quite a fair bit...

My thoughts have been revolving around commitments to VCF and academics... oriented more towards the long term view of it.. Many questions have surfaced; many can't be answered; those that can only serve to generate more questions

-VCF-
It doesn't really take much of a rational person to feel that going for VCF is "a waste of time". Considering how e.g. today, I'm back at 10.30pm, all drained and tired, knowing I need to study but simply am unable to focus. And also how the cell group/bible study discussions aren't exactly the way I expected it to be when I first joined (but definitely not implying it isn't good). Then after that comes the need for people to step up into leadership positions, of which I'm totally unsure if I can commit, or even be up to the mark for it

Now of course, those points alone would probably mean that I should have quit eons ago. But then, I come to think about how the fellowship within VCF is so warm and so cheerful; it's yet another avenue of which I can remain grounded in the Word; and the part that I sort of enjoy are parts where there are discussions, tending somewhat towards the theological side where there are differing opinions and views... nobody knows for sure who is right or wrong except God Himself. One such example: Did Jesus die for the elect, or for every single person? (and somewhere for the cats and dogs too came in o.O) It's discussions like these which lead me to probe further, and to know the Bible better. Not forgetting too that there are occassional reminders being thrown out here and there during group discussions about our daily lives and spiritual lives.

I'm supposing that the overall picture comes to what I'm doing now: Go for VCF when I'm in school (since I'm there already anyway) and probably play the disappearing act when I'm not. It all seems good, until the question about CGLing comes up. No way can I maintain this pattern of attendance if I'm to lead a group. Which brings up more questions: Am I able to commit time to VCF as a CGL? Will I even be alert enough during the sessions considering how clinicals will be so much more drianing? And most importantly: Am I spiritually mature enough to lead a group? - to the last question, I'ld doubt it.

Then comes the questions for the academic part... most of which stemmed from the dinner yesterday. Summing it all up into a bunch of questions:
~ How important, really, are grades?
~ And again, how important are they, after considering the new residency programme?
~ What is it, that we truly hope to achieve after these 5 years?
~ Do we know how exactly life would be like next time? As a GP, as a specialist?
~ Looking not so far ahead: do we/would we fully understand and empathise with the patients in the bed, who are "at the mercy" of medical students?

I was thinking about all these issues on the way home in the train... Unfortunately, instead of finding answers, my thoughts drifted to how my life has changed since uni started... I realised that since the start of uni, I haven't really had much time to think about such problems. School days were effectively burned, holidays were spent either studying or doing things that would never otherwise get done during school days e.g. going overseas, catching up with past friends etc

And how about the upcoming years? Life doesn't seem like it'll get much better. Now add on the fact that I'm currently studying at a pathetically slow rate (which would 101% mean supps if I keep this up) and the fact that, for an unkown reason, I've been ravaged by the sleep monster lately (12 hours of sleep a day would seem just sufficient for me now =s)... I really don't know where I'm currently at... ... ... And oh dear. I just remembered EAMSC too. Did I really make a bad decision joining?

So how does all this add up? Sigh~ questions, more questions and lack of time. Isn't this an evergreen phenomenon? I really don't know when I'll get the chance to find answers but somewhere, somehow, sometime I'll have to

Saturday, February 12, 2011

The 27 hour day

From 7am to 10am.

Sequence of events went from uneventful school to EAMSC interview, on to Worship Under The Stars at ACJC and then to the crazy bunch of rangers.

Thinking about whether to apply to the EAMSC comm was really a tough decision. It all had to do with thinking of how it would all balance out: EAMSC, school/clinicals, VCF. On one hand, it would be lots of fun and a load of experiencing + networking gained for being part of EAMSC while on the other hand, that would mean less time, less energy and less commitments in other areas... most notably school and VCF - at least for what i foresaw. In the end, I decided that I would just apply, and if God wills it, I'll get through the interview to be selected.

Today (after waking up at 2+pm =x) I read the sms came in - that I'm in the committee. With whatever thinking capacity I had in my sleepy state, I looked into still air as I wondered about the coming year (and also a bit on how come I got a similar but still different post from what I applied for o.O). Even right now, the planning stage has already begun and I fear to think of how busy things will get in the coming year. But as always, I take comfort in the fact that God would never put me into something without giving me the strength to go through it

Worship Under The Stars~ and a ceiling. The event was moved to the hall due to rain even though at 7pm there was zero rain left falling. Oh well, it was still great to back in ACJC, feeling the nostalgia as I walked past the north lodge, concourse, field etc. Great to see seniors, juniors and techers once again and most of all, the experience of worshipping God back in the hall. Then during the short sermon, I suddenly found out that =O i'm a J5. Gosh. Time flies. It was so long ago that I was still having fun in ACJC, virtually free of stress (at least compared to now) and so much more carefree. Time changes so many things...

Proceeded on to dhoby ghaut after that to meet up with the bunch of crazy people who choose to meet at 10pm instead of 10am. A night of LAN, movie and coffee + later breakfast... I'm thinking - for how long more would I be able to do this? But then again, I would rather stick to the standard afternoon meeting time even if there somehow is time for me to do it again lol

So ended up coming home, and by 10+, concussing on my bed after a refreshing shower. Such days are tiring, but usually the most tiring days are the most fulfilling days :) How nice if everyday was devoted to worshipping God and meeting friends... yea, that'll be good... mm... ok i'm back to reality

The coming academic year... or even now will probably will be much terribly busier than before due to EAMSC but I believe that God will provide. And in all things, I shall aim to do things for Him and not for man. LORD, may You see me through with Your blessings

Sunday, January 30, 2011

The past month

Since my last post, many things have come and gone, main highlights being CA2 and yesterday.

So i was wondering why I thought my CA2 will be just as good or rather, just as bad as my CA1 even though the syllabus was supposedly much more easy going.. then I realised that I only spent half the time studying for it than I did for CA1. Which reminds me, I better get back to studying for finals >_>

But it seems like the past 1 and a half years odd in uni has really changed my tolerance level for stress... to the extent where I can actually continue studying just that wee bit below the pace at which I would burn out at and sustain it for a whole week or possibly more... to the extent where (sadly enough) there isn't really much joy left in finishing an exam anymore knowing that the next one is just around the corner.

If you ask me, I would say that I wouldn't really expect anything from my exams. I believe that as long as I put in my personal best, God will honour my efforts and give me what He thinks that I deserve or what I need... especially so since He was the One who led me to this course

Post-CA lectures as usual aren't exactly too forgiving but again, it's probably how things are and will be for some time. Not too much point mulling over it

Yesterday was quite a packed night for me, two 21st parties (+1 more psuedo 21st ... greeting.) and a nussu bash at st james'. Nothing much to say about that day really, except that it was good to have the company of friends, both past and present, and enjoy the fun and laughter that they bring =)

Most notably yesterday, was actually how I very very nearly got into an accident... shan't touch on the details, but oh how I was reminded about how silly mistakes that I make sometimes can result in dire consequences and more so, how God protects me each time I make a mistake... Thank You LORD for keeping me safe, just thank You so so much...

Once again I want to give thanks to God for seeing me through the past month and the grace that so freely showers upon me each day. Lessons and studying may not be the most enjoyable thing to do but I'll still do it for Him

"So whether you eat or drink or whatever you do, do it all for the glory of God" - 1 Corinthians 10:31

Sunday, January 2, 2011

Midnight - school starts today

And an update.... ok so I've only completed 8 hours out of the 14 i wanted to heh. Blame it on my lack of perseverance. Things were going well on the first 2 days; 3.5 hours of webcast + study of related notes... personally that's a huge wow on my side considering how badly i've been studying XD

Then today and yesterday I just refused to study so much coz it was just so draining (12 hours of sleep a day up from 9-10 can more than testify to that). So I ended up doing only 1 more hour over the 2 days. how productive lol

Ok, so I've got to catch up on quite a bit once school starts... God has already given me a glimpse of what He can do with a bummer like me within those two days, so I believe that over the next 2.5 weeks that I have before the exams, He'll definitely show me more of just what He can do.

Anyways, school is starting in just over 8 hours and here I am still on the comp... Maybe I should have tried correcting my sleep-at-4am-wake-up-past-12 habit before today. From the looks of it (+ how I really still need 10 hours of sleep or more), chances are I'll just end up zombified again in school tomorrow. What's new right

Academics aside, the past week has been rather trying for me spiritually... Many things happening concurrently and yet independent of each other. So much for trying to concentrate on the task at hand. But I've been through worst storms; The God who has seen me through the past storms will definitely see me through this period as well.

Again, I'll see how things go, as of now, I'm better off lamenting on how 1 month of hoilidays (which is really a not so cleverly disguised study break) pass as fast as 1 week of school. Back to the study mood from tomorrow... sigh~