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"

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...

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...

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~

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~~

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.

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.

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...

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.

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