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

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.

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.

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

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

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~~