About Me

Thursday, May 28, 2015

strength in weakness

31st May 2015: Strength in Weakness

For the sake of Christ, then, I am content with weaknesses...for when I am weak, then I am strong. 2 Corinthians 12:10
It is true that our real character may be revealed in the manner in which we deal with adversity.
The Apostle Paul knew much of adversity. From shipwreck to stonings and from conflict to confinement, he frequently faced difficult times. And he learned that God does not always choose to relieve personal discomfort. Nonetheless, Paul saw God's strength as the means of overcoming periods of distress.
We, like Paul, will face difficult times. We might be over-burdened by the demands of our profession. We might find difficulty dealing with the results of personal failings. Or we might face overt persecution as we stand firm for God's ways. Paul's example can serve to instruct and encourage us as we face undesired situations.
Paul realised that he was not omnipotent. He even suggested that some of his discomfort, his 'thorn in the flesh', was intended to remind him not to exalt himself. We too must face up to our own limitations.
Paul knew that God is almighty. He realised that God's power was also personally applicable. He could, he told believers in Philippi, do all things through Christ. It was in facing up to his own weakness that Paul was able to appropriate God's strength. Thus Paul found his utmost strength in his own weakness. Perhaps we can avoid some of our own difficulties by recognising our own weakness and calling on our strong God before we get ourselves into trouble.
With God's strength, Paul knew how to live through adversity; he persevered. He could be down but not out. He could be perplexed but not despairing. He kept living with the attitude of a servant despite the adversity in which he found himself.
Like Paul, we shall face adversity. We, too, must learn to recognise our own weakness, to appropriate God's strength, and to keep pressing on. Thus, we can shine brightly even in seeming defeat.
~

1st June 2015: The Voice of Stillness

'... and after the fire a still small voice. 1 Kings 19:12
Does life ever overwhelm you? So many things can happen -- good things, bad things, all kinds of things -- that they knock you flat. Do you wonder when they will stop -- when the tumult will cease? Can medicine never be the quiet life?
Elijah was one of the great men of God, but things got him down sometimes. When Jezebel put him on her death list he packed up completely. Rather paradoxically he asked God to let him die. God treated him gently and strengthened him. He wandered off, but was obviously still unhappy. He came to Horeb, the mount of God, took refuge in a cave and had another attack of the miseries, pouring out his heart to the Lord in a stream of self-pity.
This time God was not so gentle. Elijah really got the treatment: 'And behold the Lord passed by, and a great and strong wind rent the mountains, and broke in pieces the rocks before the Lord, but the Lord was not in the wind; and after the wind an earthquake; but the Lord was not in the earthquake and, after the earthquake a fire, but the Lord was not in the fire...'
God was showing his power. Elijah apparently needed to be made aware of it. The demonstration must have been terrifying, but Elijah had to learn the hard way. The demonstration had, however, been made, and the message was getting through. Elijah was ready for something different, and something different came: 'after the fire a still small voice'. Another translation says: 'a voice of stillness'. And in the stillness he was again able to tell his troubles.
Somehow the atmosphere is now different. Perhaps in the stillness Elijah is now listening, really listening. God shows him the way ahead. Communication is restored. Confidence is restored.
The story is worth pondering. Sometimes we think we have had enough, whether it is sheer physical exhaustion, deadness of heart, discouragement, even a sense of spiritual abandonment. God may then treat us gently, and we at least pretend to take the healing with gratitude. But we may not be really listening. Self-pity can cause severe deafness. And God may have to give us the treatment, as he did to Elijah.
The experience can be rough and tough and tumultuous.
'Where is the god of love?' we then ask, unheeding of the fact that Love is shouting at us. When we are ready to listen, then -- only then -- comes the still small voice, the voice of stillness. And in the stillness God reaches us.

~

if there is strength in weakness, i must be REALLY strong haha. nvm just keep plowing on. it maKEs me a better dr. and maybe a better person too. and preshift chocolate really makes life better like you wouldnt imagine. post shift chocolate too. just chocolate in general

Wednesday, May 27, 2015

wk 3-4: around 9-15 patients/ day! yay!
although i did get scolded for being slow on the day i saw 15 pts... on the bright side i learnt how to speed up after that :)

my current wishlist is:
1) to make it for cmg mass on friday (my off day! pls dont call me back for standby..)
2) to survive tdy's shift
3) to find one hour in a day where i actually feel like studying (im always too shattered/ sleepy to actually do anything other than watch tv hahah)

Wednesday, May 20, 2015

wishlist

1. to make impossibly fluffy buttermilk pancakes
2. to one day see 15 patients in a shift
3. to eat dinner during a shift
4. to go on vacation
5. to finish reading nelson's from cover to cover

Monday, May 18, 2015

sometimes there are some things you are willing to do anything for
to try no matter how many times you get knocked down

those are the things in life you should fight for

reflections on wk 2

sooo after 2 weeks, i have concluded that this is not rocket science (as it initially felt like). the guidelines are slowly being imprinted in my brain & once you know your guidelines well, it makes things MUCH faster coz u can send people home fast, or just adm them faster if they need admission. and you can just summarize the case faster to the con/reg instead of presenting like a medical student "this boy has fever for 3 days... cough for 3 days...". and i have also learnt to DO CXR FOR SUPER LONG COUGHS. the other day the reg and i were looking at q a florid cxr and she was like SEE i told you need to do cxr! *humbled*.

also, really enjoy doing fluroscein stains on little babies. v satisfying and amazing that i can do it! although i think this eye reg must be like wondering why the same mo keeps calling her about small babies. btw people if you ever get conjunctivitis, do NOT rub your eyes. just a tip.

week 1: 6-10pts/day
week 2: 8-12 pts/day --> yay?

used to think that working in an emed dept would mean that when the shift ends, one can just go home and switch off. NOT TRUE. well its true in the sense that you dont have to stay behind and hids, and its not like med sch where you need to perpetually mug for the next mini-cex. on that note, seriously so glad for med sch. since whatever i do now is predicated on whatever i learnt in med sch. LOL. thank goodness for all that mugging. there's alot of wondering WHAT IF and if you did the right thing.

anyways, it's a new week! and hopefully i can hit 15 pts this week? need to sing for my (often cold) suppers! and also need to learn to heat up aforementioned suppers. it's really nice of them to give us food :)

Friday, May 15, 2015

on pulling rabbits out of hats

14th May 2015: Guidance (3) -- Conductive Deafness

He who has ears to hear let him hear. Matthew 11:15
There is a saying that there are none so deaf as those who won't hear. It is possible to shut our ears purposely (Zc 7:11). In fact problems of the will may be more significant than those of spiritual perception. Words of Jesus, taken completely out of context, yet enshrine a principle, 'If any man's will is to do his will, he shall know' (Jn 7:17). It is true in experience that not until we are truly willing can God make clear to us which of the options before us is right. This may involve a major spiritual battle. We may think we are unbiased when we are not.
God's guidance may come in the language of a look (Ps 32:8 AV) -- provided that we are watching for it (Ps 123:2); or by the whisper of the Spirit in the heart, as with Simeon and Philip (Lk 2:27; Acts 8:29). If we do not hear his whisper, he may speak, or even shout to make himself heard. If we are still unresponsive, he may need to 'goad us' to attract our attention, or even to stop us in our tracks (Acts 26:13-14). And all the time we are wondering what is happening to our lives!
The trouble sometimes is that we are seeking his will with minds already made up, and asking him to confirm our plans rather than reveal his own. We can deceive not only ourselves but other people into thinking that we only want God's will, thus effectively stifling any further discussion in the matter.

15th May 2015: Guidance (4) -- What if things go Wrong?

This man could have been set free if... Acts 26:32
There was no doubt about the rightness of his decision. Directed by the Spirit he had planned to visit Rome (Acts 19:21). His wish to go was certainly of God (Rom 15:22-24), and his call was later explicitly confirmed (Acts 23:11). Paul saw the future mapped out in front of him; he would finish his work in Macedonia and Achaia, deliver the gifts to the church in Jerusalem, then set out for Spain via Rome.
But things went badly wrong. Arrested in Jerusalem because of a total misunderstanding (Acts 21:28-29), he became the object of a smear campaign. The scandal grew. His enemies were quick to cash in on the situation and brought charges against him on accusations that were totally false and which he persistently and vehemently denied. But it was no good. The trip to Spain was 'off', and he found himself instead unjustly jailed for two years in Caesarea (Acts 24:27).
And then -- what irony -- justice at last -- but too late! Agrippa's judgment was in his favour, 'this man is doing nothing to deserve death or imprisonment...He could have been set free if he had not appealed to Caesar' (Acts 26:31-32). Had he made a horrible mistake? could he have gone to Rome and Spain a free agent just as he had originally planned?
But Paul's plan would never have materialised. He would have been murdered in Jerusalem before he even started, God's plan was better. He actually used Paul's captors to save his life, to facilitate his work and to ensure the spread of the gospel to the west. Five times the Romans saved him from death (can you find them between Acts 21:31 and 27:44?). They gave him free and safe travel, so different from his missionary journeys. Not least they gave him guaranteed accommodation for four years under military protection, with his friends coming and going at will, with freedom to preach, teach and write unhindered (Acts 24:23; 28:16-24, 30-31).
Worried about injustices in job appointments? about unfairness and favouritism? about the malicious and false things people say? Afraid that God's plan for our lives is being spoilt? Our plans may not materialise, but God's always do.
~

had a very very humbling and demoralizing shift, yet the most inspiring of my entire life. am a great fan of the metaphorical being kicked in the ass, nothing like that to make you buck up STAT. the inspiring bit wasnt the part where a six year old drew me a picture of a magician pulling a rabbit out of her hat (im sure the sixyr old didnt mean to remind me of how slow i am, but if my pt can draw a magician in the time it takes me to document my neuro exam findings....) anyway it was really sweet of her, no qns bout it :) the inspiring bit was the ass-kicking bit. really need to step up and be an mo. the problem is i have NO IDEA how to be an mo. yeah. that's the truth. hellow ive only done this for 2 weeks! im learning, albeit very, very slowly. i wish i could learn abit faster. or maybe that if i just knew how to act like an mo and magically knew everything; i guess if i was a magician and could pull rabbits out of my hat or do magic tricks, maybe somehow i could magically see 20 pts a day. not 8. (secret tip from a 6 yr old maybe?) 

anyway. there are things i can change & things i can't, things i thought i couldnt change but actually could. by the end of this year (eh actually by the end of this posting. or maybe by next wk. or best of all starting tonight would be ideal), i need to prove to myself that i can step up as an mo and DO IT. i dont have to get my foot into the door of anything. i dont actually care about the physical paper accomplishment part of it. 1 yr ago i would have been paralysed with wondering WHAT DO I DO WITH MY LIFE. i honestly don't care anymore cause there are many ways one can do God's will even if i dont take the EXACT SPECIFIC path my 22-23 yr old self envisioned. you just have to look for the ways to do it, if you really want to. after twenty-five yrs of existance i have finally come to the understanding and maturity to accept that his ways are higher than mine. took a bit long heh. it's actually kind of nice to be in a position where i can truly be at peace with the knowledge that even if what i planned does not materialize, as long as God's does, that'll be ok. probably better. THAT i'll attest to. im actually kinda looking forward to what his plans are, since they're universally better than mine. 



Wednesday, May 13, 2015

keep on course

13th May 2015: Guidance (2) -- Keep 'On Course'
I being in the way, the Lord led me. Genesis 24:27 (AV)

God's guidance is a natural consequence of being 'on course'. Anything that disrupts our fellowship with him obscures our vision and blunts our perception. Given a right relationship with God, his guidance may be unobtrusive, almost outside our conscious awareness, many decisions being dictated by common sense, albeit the common sense of a renewed mind. God promises to guide the meek in judgment (Ps 25:9). We are not to be stupid and mulish, to be pushed and pulled, but to be those with understanding minds enlightened and instructed (Ps 32:9), attuned to the mind of Christ. Maybe we can see only one step ahead. Take it and the way will open as do automatic doors on our approach.

Guidance may be by restraint. In Acts 16:6-10 Paul and Silas were forbidden by the Holy Spirit to speak the word in Asia. How (since it seemed so good a thing to do)? By a spoken word? a vision? or just a disquiet of heart, a lack of assurance, an unease, a 'something' that held them back? Then they saw a door marked 'Push'. They tried it. It did not yield (no harm in testing the doors). God has promised to tell us if we take a step in the wrong direction (Is 30:21). But for every door that closes there is one that opens. The invitation came to Macedonia. They weighted it up. They became satisfied ('assuredly gathering' AV, 'concluding' RSV) that this was God's call. Immediately they pushed forward. The way opened up. The wide door for effective work in Greece lay open, and it was a door that none could shut.

But sometimes God not only restrains us, he 'ejects' us from where we are. Paul longed to preach to the Jews (Rom 9:3). For this he was eminently fitted. But God had a different sphere for him, hence his rejection by the Jews; 'make haste and get quickly out...Depart, for I will send you far away...' (Acts 22:18-21). Well qualified for a particular appointment? Trained and prepared for it? in 'the running' -- even promised it and then by-passed? Don't bang your head against the brick wall of non-acceptance. Sometimes a misfit in one sphere is eminently suited for a successful and fruitful life in another. (But -- be certain that your rejection is not due to unpleasantness or incompetence!)
~
“Dear Lord, I pray for your guidance and grace to be a good doctor in the wards/ emergency dept. There are many things I do not know, and many uncertainties out there. Help me to be humble to ask when in doubt, guide me in doing the right things for my patient, and help me to be your healing hands to those in need of your healing touch and love around me.”

~
“Thank you, Lord, for the trials that come my way. In that way I can grow each day as I let you lead,
And thank you, Lord, for the patience those trials bring. In that process of growing, I can learn to care.
I thank you, Lord, with each trial I feel inside, that you’re there to help, lead and guide me away from wrong.
‘Cause you promised, Lord, that with every testing, that your way of escaping is easier to bear.
I thank you, Lord, for the victory that growing brings.
In surrender of everything life is so worth while.
And I thank you, Lord, that when everything’s put in place, out in front I can see your face, and it’s there you belong.”
~
wk 2 of work, blends into a never-ending stream of patients. the balance between spending too much time on one patient vs all the cases streaming thru the see immediately corridor. it is very hard to see three cases immediately all at once. nearly impossible..was discussing with f that this is like mbbs on crack haha. yknow the case where they made us take hx pe and counsel patient all in like 10mins. EXACTLY like that. and you get interrupted multiple times to see emerg cases in that 10 mins. and you cant say anything too alarming when counselling the pts. and you dont have time/ are unable to surrepitiously flip the guidelines before going to present to the cons. well i guess thats similar to exams coz you cant flip any notes during exams also HAHA. on the bright side, the guidelines stick REALLY well in my head after each chastisement. i guess i do learn best this way (lol?). and on the even brighter side, i can show IMPROVEMENT (aiya give chance la... first 2 wks right?).

on doors: its true that one never really knows which doors are meant to open and close and the only way is to push on the doors and find out. some can't be shut by anyone and some cant be opened by anyone. some doors, i know i am not meant to open. that's why, i didnt choose to even try opening those doors. because i could see where others had gone before me, that those doors don't lead to happiness, those doors don't lead to the right direction. this door seems like the right one. by all accounts. maybe its like alice in wonderland, i just need to eat the magic cake & drink the magic drink and ill be able to get the keys for the doors.

but then again, i think it really isnt just about the doors. its about one levelling up from the current NOOB status, to doing a good job wherever one is. the actual title or status is secondary. id rather be just another faceless mo, doing a gd job, rather than having any title and being noob. of course now i am neither of the above. i am probably a very obvious noob mo currently. lol. i am under absolutely no illusions about my capabilities. but as the past 1/4 of a century has shown, i am also very good at levelling up. (just that all these late night shifts make me very sleepy lehh).

soo in conclusion, i will and i must somehow level up, stat. how this is gonna happen, not sure, but maybe a lot of hard work and many mini-miracles could make it happen. (story of my life). miracles, i cant control. hard work, i can (sleep-wake cycle changes notwithstanding).

aim for today: see 11 cases, burn guidelines on memory (or find way to surrepitiously flip them at some place), phrase qns to seniors leadingly and intelligently (e.g "...., prob need to admit right?" not "blah blah blah.... *trailing off sentences* - when i actually KNEW adm was likely -_-). and see pts faster, fullstop. oh, and get to eat dinner at some point. hopefully at peri-dinner time, not at 2am. actually, aim HOME BEFORE MIDNIGHT (haha hopefulness)

Monday, May 11, 2015

its way beyond me/ be not dismayed

30th June 2015: Be Not Dismayed

Be not dismayed. Joshua 1:9
The exuberant on-top-of-the-world life is not for all of us. True, we may experience this feeling at special times, immediately after our conversion, or when we pass 'finals'. But the mountain top experience does not last, and we often have our setbacks. Things go wrong despite all our efforts. The word said in kindness is misunderstood. Lack of sleep last night and the night before takes its toll, so that it is all too easy to wonder whether all our efforts are worth it, and whether it is any good to go on striving for excellence. Would it not be better to alter our standards and, indeed our job? Why ever did we do medicine at all? Dismay can seep into the soul and affect our way of living and our reason for it. One of the first things to suffer is our life in Christ, our prayer time, our Bible reading and our everyday witness. That is why Joshua was told that he needed courage and strength to go on studying and obeying God's word (Jos 1:7-8). The murmurings of the discontented people of Israel did not leave Moses and Joshua unscathed. Some of the rebellious talk sank into their souls (Nu 11:10-15). That is why God had to say 'Be not dismayed'. It required an act of obedience by them -- and it does by us too. This is a command for us to obey. Not to be dismayed is one of the hardest things to do. It requires much prayer and trust and can be one of the biggest trials of our faith.
The houseman years can be very difficult. After the friendship of the Christian Union, the joy of graduation, there follows the time of testing. The long hours, the responsibility which at times is awful, the calls which demand a knowledge and skill well beyond any preparation that the medical school gave us, these sap both our physical and spiritual strength. The n'th job applied for and denied, another intravenous drip into the tissues, the third dry lumbar puncture in succession, the families who break up before our very eyes, these all tax our courage, tenacity and Christian faith. And, just when we need it most, time for God is at a premium. The man of the world tackles the possible, the Christian the impossible. To do so the Christian requires not only courage but 'stickability', tenacity, the ability not to be deflected by dismay and the sure knowledge that he is commissioned in his everyday work by the King of Kings, who gives the strength for each new demand and who does not measure a man's life by worldly achievements but by his acts of obedience.
When we have exhausted our store of endurance,
When our strength has failed ere the day is half done,
When we reach the end of our hoarded resources,
Our Father's full giving has only begun.
His love has no limit, His grace has no measure,
His power no boundary known unto man,
For out of his infinite riches in Jesus
He giveth and giveth and giveth again.

~
this i know, that whatever his plan for me is, i'm thoroughly enjoying the ride. even tho the responsibility sometimes scares me ++ (esp the newfound responsibility of being an mo... like sometimes when i send a very obvious urti kid home, like fever for ONE DAY with runny nose ++ and whole family having runny noses... and i pray very hard that indeed its just urti and emphasize to the parents to BRING BACK if still having fever in like 4 days time  'aunty normal cough and cold shld recover by one wk ok PLEASE BRING BACK if baby is not well!!'). the feeling that that whether im meant to do this or not, its really such a joy to be allowed to do this posting that is literally one of my childhood dreams (lets take yr 1 of med sch as being inclusive of childhood since i still felt v young and inmature then HAHA). 

even though the ONE MONTH of very late night shifts makes me very very zzz, somehow its the first posting that i actually look forward to going to work everyday. or shld i say, every night. lol. my last posting had a very perpetual chronic school refusal thing going on which was quite the severe, particularly pre-night floats. for this posting, i feel like i cld do anything anyone asked me to do with no complaints whatsoever. never loved anything so much before. 

on another note, it occured to me why there is such a stringent criteria for med sch and why they like to take pple who do many ccas/ outside activities. coz the amt of multi-tasking in emed depts is WHOA. you really need to be like an octopus its no joke. i really respect this dept for being so good-natured despite some nights being v crazy like a zoo, no one ever shouts at anyone. its amazing. my last posting people were forever shouting at each other (some nicer than others, like the enthusiastic lw nurses: HO AH! SET PLUG!)

ok. must memorize guidelines by THIS WEEK. (as we have been instructed by the con.)

11th May 2015: Beyond the Reasonable Call of Duty

Whosoever of you will be the chiefest, shall be the servant of all. Mark 10:44 (AV)
This passage is worth reading in its full context, for it is preceded by the episode in which two disciples asked for the chief places in the Kingdom, and Jesus countered them by saying that true greatness went with service and ministry. It is followed by the episode of blind Bartimaeus, sitting by the highway begging.
Bartimaeus cried out to Jesus as he passed by, only to be hushed up (by the healthy, one supposes!). He was getting in their way, a nuisance, preventing them from doing what to them was more important. But seeing his fleeting chance of help Bartimaeus refused to be silenced, and Jesus was not one to stand on his dignity -- he had come to serve, not to be served. Here was one needing service. Jesus always held himself available for people like Bartimaeus.
One of the problems of being a doctor is that so many people seem to expect us to be available at all times. They may not necessarily be patients -- they may be relatives, or nurses needing some question answered. Often the request for our time comes when we are tired, or are just leaving work for some well deserved relaxation. Often the request seems unjustified and trivial compared with our need for some privacy and leisure. Yet when and if we answer the request, we often find that it is more urgent than we had anticipated, or that it reveals some unspoken anguish or misapprehension at which we had not guessed. This is not always so -- sometimes the request really is trivial. But if we are following in our Master's footsteps, we dare not stand on our dignity and behave as if we were 'the great ones' not to be troubled by trivia. 'For even the Son of man came not to be ministered unto, but to minister, and to give his life a ransom for many' (v45) -- the key to our reading.
Lord help me not to be impatient with those who make
what seem to be unnecessary demands on my time.
Give me the grace to be courteous, and ready to give
of myself to those whose requests appear trivial
but whose needs may be greater than I realise.
Further reading: Mk 10:35-52.

12th May 2015: Guidance (1) -- Recognising God's Guidance

The Lord will guide you continually. Isaiah 58:11
God's promise of guidance is certain and repeated. He has recreated us and has a prepared plan for our lives (Eph 2:10). Jesus himself promised that his followers would not walk in darkness but have the light of life (Jn 8:12). Yet recognising God's will remains a practical problem, particularly perhaps for junior doctors who have to make frequent job decisions which could determine their whole future. We can be caught between the Scylla or rushing ahead with our own plans, assuming them right, and the Charybdis of being reduced to jittering indecision, lest we are making a mistake.
The following stem from long experience:
1. God is more anxious than we that we should know his will, trying neither to delude us not to obscure his plans. But his promises are not magic formulae triggered with a magic wand. We are not always ready for the answer for which we ask. God's promises are often conditional on prerequisites in the recipient. 'In all thy ways acknowledge him and he shall direct thy paths' (Pr 3:6 AV). 'Seek ye first the kingdom of God...and all these things shall be added' (Mt 6:33); 'If ye abide in me, and my words abide in you, ye shall ask whatever you will and it shall be done for you' (Jn 15:7).
2. God sometimes withholds guidance, having some better thing for us, 'therefore the Lord waits to be gracious to you' (Is 30:18). His delays are for our greater blessing.
3. Guidance comes in different ways to different people and in different ways to the same person. He is a living God of resource and initiative, seldom working in the same way twice. We sometimes pray for guidance and fail to recognise it when it comes.
4. We may not be acutely aware of God's guidance at the time, but with hindsight can see how unerring it has been. A multiplicity of 'coincidences' of circumstance and timing assure our hearts of his good hand upon us. In his good time we see the picture emerging from the jig-saw pieces.
~

stats

D1 6 pts
D2 10 pts
D3 8
D4 8
D5 10

aim for wk 2: > 10 pts each day! and try to leave on time for once. hahah

Tuesday, May 5, 2015

daily inspiration






resolutions/a little bit closer

1. see 20 patients a shift. ok. i think i should start with aiming for double digits. like maybe 11. HAHA. bring on the urtis!!
2. study 1 topic a day!
- topics to mug: nnj/ asthma/ uti (makes me faster when seeing common conditions)
- ortho/ eye/ ent (makes me faster when seeing slightly out of the common conditions). also i want to do my first backslab sooN!
3. quickly finish sedation module so that i can start getting up the nerve to start doing sedation (its a v useful skill!)
4. which brings me to T&S, i really want to do one!
5. need to review inx faster!

in summary, i just need to be fasteR. actually i have the basic (verrry basic) knowledge. i just need to figure out the computer system. but really grateful for all the clinics i've been forced to run in ho yr (like in gs as well as pat). really prepares you much better for these 5 min pt encounters.

the funny thing is i always have all these aspirations but each time i start a new posting im acutely aware of how much more i have to learn! a lot of the time it really is due to new systems and once you get used to the workflow ur muchh faster and much more efficient. i think i was quite an ok o&g ho towards the end. haha.

eventually i'll get closer to where i wanna be, eventually i'll get good at this, whatever this is :)

ok i aim to see 12 patients on my shift tmr. and close the case v fast and trace all their inx v fast and have them leave my consult room happy. haha one hopes.

Monday, May 4, 2015

the night before

5th July 2015: The Night Before...

Have I not commanded you? Fear not. Joshua 1:9 (NIV)
There are some who appear positively to enjoy a lecture to a big audience, or presenting a case for the seminar or grand round. It is a challenge, and they delight in it. But for most of us these occasions are associated with a fearful apprehension that gives us an uneasy night's sleep beforehand, and a quickening of the pulse and paling of the face at the time. Yet these things have to be faced. The words given to Joshua can be a great support to us: 'Fear not, have I not commanded you?' The Christian goes as God's ambassador about his daily duties, and this includes public appearances. As an ambassador he does his very best, prepares well beforehand, rehearses, thinks about the important points and seeks the help of others. But having done all this, when the occasion comes, he goes as a servant of the living God, even though speaking on secular matters. He relies on the strength and courage that God gives in response to his prayers and know that God will be with him. The words he uses, the standard he sets, the grace and consideration he shows towards the patient whose case he demonstrates, these all come from his maker. And so the burden becomes lighter, the accomplishment greater, and God's name is honoured.
Joshua did all that was humanly possible to prepare for the taking of Jericho, and he was right to do so. But, military genius though he was, he only found victorious power when, on the eve of the battle, he met the Captain of the host of the Lord, drawn sword in hand, and fell down and worshipped him (Jos 5:13-15).
It was for Joshua to do his best in total reliance on the Lord. It was for the Lord to magnify him in the eyes of other people as he saw fit (Jos 4:14).

Teach us good Lord to serve thee as thou deservest,
to give and not to count the cost,
to fight and not to heed the wounds,
to toil and not to seek for rest,
to labour and not to ask for any reward
save that of knowing that we do thy will.
Ignatius Loyola

~
somehow the night before turning mo is even scarier than the night before turning ho. haha. i remember vividly one year ago when i walked into the paeds ward my very first day of being a doctor and i heard a baby /little kid crying from somewhere in the ward and i turned around and walked right out of the ward in a panic. 

actually when writing my reflections for the juniors i wanted to tell them "guys there is this website called DOCTORS LIFE SUPPORT. READ IT. certain passages will speak to you at random different times and often will save you." but then i didn't. oh well. there is something comforting in typing into google DOCTORS LIFE SUPPORT, i must say. pwaha. 

i hope i have been a good ho. i dont know if i have been the fastest or the most efficient ho on earth but thus far all my patients survived, more or less, and i know i definitely did the best i could, often going beyond what was required. i actually greatly enjoy doing much more than what is required, it does make me feel v satisfied hahaha. 

sadly something tells me being a good mo requires a lot more than just mary-poppins level organization skillz. at the end of this year, just beginning to read a 400pg guidebook, i realise there is so much MORE than i dont know. a lot of ho stuff is tips and tricks that just help you survive one call. there is so much vast knowledge out there. kinda scary actually. and very hard to call ur mo for help now. HAHA. 

interestingly enough i think this yr of ho ship has changed ME.  its really like that navy dude said - all those early morning circuses make you a stronger person. it definitely made me a lot more reliable and responsible. coz half the time you can't NOT be, there's so much riding on your own responsibility and capability. i'm really thankful for that. and also you get much more aware of maslows hierachy of needs. like SLEEP and WAFFLES and people to share the wafflez with. yup those are important things. 



(story of my life)

Sunday, May 3, 2015

you're not alone

i survived HO-ship!! *amazed*

my last call was actually fairly okay, to the point that at around 2am i went up and started hidsing up the postnatal patients who were due to go home that day. the nurses were highly amused. i also spent the morning surrepitiously writing very last minute reflections on ho yr for the cmg tea that i was precluded from attending due to aforementioned last call, in between discharging patients. quite a fitting ending to the year really. the only thing is that despite predischarging half my pts i still ended up going home at 330pm due to arranging a lot of e-ops sigh.

so tomorrow after getting my last form signed off and listing my last patient for surgery, i'll be officially a mo! :) thank God, literally.

this last posting has been actually really fun on hindsight and everything i wanted from it & more. initially i actually just wanted to catch babies and be in this hospital to do my research. i didnt actually physically catch that many babies since usually im occupied with stitching up their mothers or ordering postnatal meds, did do some research tho. but i learnt alot abt how the emergency ops work and how to run to ot stat! which will def come in useful for neonates. i also cooed at plenty of babies at midnight when ordering their vaccines and took the opportunity to sneak into nicu whenever i could (e.g when instructed to go and check on pt's babies for them). the fellow hos in this posting have been AMAZING. they made an otherwise stressful posting where we are all on our tenterhooks trying not to get scolded/into trouble much more than bearable.

things i learnt from this posting
1. how to tie surgical knots :)
2. how to list an emergency c section
3. how to set plugs and take blood with nearly 100% sucess rate (c.f. my two night floats yo!) seriously thank you o&g, this is the best thing that could've happened to me. (ok so my last call there were 2 very difficult veins i couldnt get crap but that doesnt count coz i soldered on this call despite my severe dysmenorrhoea but anyway satish got them eventually while i took 2 other bloods for him hahaha so it kinda evens out lehh).

it's been awesome man. now need to go read the ce guidelines from cover to cover. let's hope my mo postings are as blessed as ho yr has been.



Some days I barely hold on
When life drags me down
I wanna let go
But when my spirit is weak
You come to my aid
And strengthen my soul

I'm lost without You
I'll never doubt You
Your grace is beyond compare, ooh
And though when it rains, it pours
You know all I have is Yours
You smile when you hear my prayer

You rescued me and I believe
That God is love and He is all I need
From this day forth for all eternity
I'll never wander on my own
For I am Yours until you call me home
I close my eyes and I can hear You say
You're not alone!
You're not alone!

Some days I just can't go on
I stumble and fall
And I hang my head
But You reach out for my hand
And You lift me up
Again and again
Oh, yes, You do

I'm lost without You
I'll never doubt You
Your grace is beyond compare, ooh
And though when it rains, it pours
You know all I have is Yours
You smile when you hear my prayer