Sleep cycle

Gosh, my sleep cycle had been disturbed in the last few days.

This sleep cycle problem started last Friday when I had a full day (a real 8.30am-4.30pm) then went onto having a long night shift. I am not kidding. I was practically on my feet all day.

Antenatal clinic in the morning followed by teaching sessions (sat for a bit). Then I walked home (as part of my 30mins walk-each-day) and went straight to bed in view for long (and arduous?) night. Night shift started at 9. Nothing much (assisted in few -normalvaginal- deliveries) and I was with my favourite registrar all night (or should I say 'all morning'?). She taught me few things and we chatted a lot to kill the time.

I left the delivery unit at 7am and went straight to train station. Journey from smallcity to BIGCITY took about an hour. Then went aboard the coach heading to London. Slept all the way (shocking!! not!) Arrived in London, joined in the demonstrating crowd (refer previous post). Slept all the way back. It took us very long to get back to BIGCITY. I wonder at what speed did the driver drive the coach? (seem ages!)

Crashed at one of my friends place in BIGCITY as it was already too late to get back to smallcity. Next morning did a bit of shopping in BIGCITY. By midday, caught the train back to smallcity. Slept again. This time purely because I felt sick. You know the kind of sick/nauseous when you are just extremely tired. Ya, that one!

Arrived at (home sweet) home by 2pm and slept until 6pm. Took 2 paracetamol. Which worked wonders. Had a long hot bath and big dinner. Went to bed (for good and) for real by 12pm.

Monday morning, I had to be at delivery unit by 7am. I swear to God, it took me every ounce of my strength to get out of bed. I was almost delirious. Seriously. I must have look groggy then, as the midwife I was attached to offered me a cup of coffee almost immediately. After that, I think I looked more humane. The staff must have thought that I was nursing the world's biggest hangover. I was not. But maybe, hangover and severe withdrawal from SLEEPING!

PBL in the afternoon. No comment.

By the time I'm writing this, I am yawning. Annoyingly, I cannot go to bed just yet. Trying to regulate the cycle to normal. That and of course I need to read about gestational diabetes (for tomorrow morning I am gonna attend Diabetic Antenatal Clinic).

What happens if I take melatonin tablets?

What do we want? END OF SIEGE!!!

What do we want?
END OF SIEGE!
When do we want it?
NOW!!!

That has got to be my fav phrase from the Demo held in front of 10 Downing Street London on Saturday 26th JAN 08. The demo was intended to create and instill awareness about the economic blockade impinged by the Israelis to the Palestinians of Gaza and to get our voices heard. Basically to put pressure on the British Government to stop supporting the 'criminal' act against the Palestinians. The blockade is getting out of hand really. Not only economically, the oppression is now extended to many other basic human rights including the health provision.

The student union of my university (gosh, I nearly give out my identity then!) had organized a coach trip to the demo for its students. And the journey started out early Saturday morning. I slept all the way through, but not after being briefed by my fellow demonstrators about the latest situation in the GAZA strip. It was appalling.

I remembered seeing images of thousands of Palestinians walking across the Palestine-Egypt border. And what a horrific view it was. Interviews with the Palestinians are even more touching. They claimed that since the wall between Palestine and Egypt was knocked down (physically and mentally), they have been able to have FOOD. A simple yet very essential modality. Something that others won't have any problem to get.

Israelis has put the Palestinians in such a terrible economic isolation since the second intifada (more than seven years). Of course the cease-fires and bombings! (Who can forget that?) I think by now almost hundred of thousands of Palestinians were killed on their own lands. It is heart renting to know that they become refugees in their own land. Recently, the Zionist Israelis had imposed an ever tight economic blockade, denying the people of Palestine their right for food and other necessities. Power shut-down, unemployment, overwhelming deprivation and almost non-existence education.

To make matter worst, now civilians needing medical help are refused entry to neighboring countries. About 1700 (and counting!) Palestinians were dead following this ridiculous isolation either due to refuse entry or inadequate medical provision in the Palestinian's hospitals themselves. It was completely awful. And yet the world is turning a blind eye on this matter. Demonstrations were held all over the world, but certainly, nothing will happen/help if the big forces like U.N doesn't stop this for once and for all.

For an overview of what is actual situation in GAZA STRIP please click here.
For an interactive details please click here.
Latest news from the Observer, UK

(yet) another interesting day (pardon all the F words)

It started off quite badly with the first ever word coming out from my mouth this morning was "FUCK!!" It was 8.45am when I actually have to be at the hospital by 8.30am. Thought about several excuses while I was on the bus to get to hospital.

'got caught up at the GP' or 'ankle swollen- have to see GP' or 'my housemate is sick with persistant d+v, went to A&E with her' or 'does it really start at half 8, i got it written down as half 9 in my diary'

When I arrived at the Ultrasound Unit, I apologized for being late and came clean "I'm so sorry for being late, I overslept!" To which the sonographers were all fine with. Good.

I saw a lot of routine USS for pregnant ladies (this is the fetal kidney and bladder bla bla bla) and ?cyst and ?bicornuate (having two uteruses). The session was all chill out until the very last patient came in with fetal cardiac insufficiency (reduced end diastolic flow during Doppler studies) and a senior consultant was called in to make decision about termination of pregnancy. I didn't quite understand the degree of the problem. All I know it was apparently non-viable!

Went to the outpatient department to be greeted by the current girlfriend of my-ex! Fucking hell. She. Why she? Why she of all third year medical students? Why she of all third years doing a special module with MY CONSULTANT???? Why! I mean to be fair, she's a nice lass. But we are talking about the girl that my ex cheated me for! ARRRGGGGHHH..

I don't think she knows who I am. She seems friendly to me, asking appropriate questions at appropriate time and being as pleasant as she could be to the whole team. I told my consultant about her status in relation to mine. He gave her a glance over and said to me :whats the odd?

I think she's better off not trying to win over MY CONSULTANT. Bloody Fuck Off-- he's mine!

Then, my consultant was called to a Caesarean Section. I said I want to head off to the theatre with him and she wanted to go as well. What? What the hell was this all about? Fuck off.

The baby was premature. So tiny. So cute. There was like so many people in the theatre: The O&G team, the anaesthetics team, the Neonates team, the theatre nurse team and the mom+dad. Length of this baby is probably less than that of an A4 paper. The O&G team made me proud: they worked so fast!

And the whole time I was there, she was tailing me! Oh God. The only consolation was: she's so nice. I dont have the heart to tell her off (no matter how uncomfortable I was). Well, I just have to deal with this professionally now. Booooo!!!

As the CS finished, I got back to the Outpatient but not before I told her to send my love to my-ex. Lets see what he's gonna make out of it! HAHAHAHAHAH.

Of course (now) I fucking hate this guy. And again why the fuck that it is her with MY consultant?

Back in OPD, I removed and inserted few pessaries. The size of which make me awed. Did few speculums and took few swabs. I still shake though while doing VE. The (distinctive) vagina's smell in itself is enough to make me feel nauseous. I certainly got better in doing it. Good girl!!! (Editor's note: Remember that p53 have a profound fear for vagina. She still hate looking at it. but what an improvement! Well done!)

Left hospital at half 5pm. What a day!

All this with me limping. The ankle swelling had reduced but there was still pain with weight bearing. Ibuprofen helps. If I continue to limp in next two or three days, I will give A&E a visit (to ensure prompt x-ray excluding microfractures).

My ankle is swollen.

Oh my god..... my right ankle is swollen!!!
I don't want to go to school tomorrow. Waaaa...

This is the first time ever (in my life) that any part of my body had swelled up. Mild swelling around the deltoid ligament on the lateral side of my right ankle 5hours post 5k run on the treadmill.

Don't want to end up with bruise. No.

Implanon

I had seen so many implants (in this case IMPLANON- the progesterone contraceptive method with a very low failure rate) being inserted. This morning I saw one being removed. Ouch. It looked painful (but I didn't tell this to the patient who was facing to the opposite side). There was a lot of blood coming out from such a tiny cut (2mm).

Patient: I can feel the pushing.

Doctor: That's normal. Its the pain that you shouldn't be feeling.

Patient: (Looking at me) Does it look gore?

Me: No, not at all.

Doctor: She'll probably seen worse in her surgical attachment.

Me: Hmm... this is nothing like 'The Hostel" if that what you're thinking.

Doctor: What's hostel?

I'm sure she'll end up with BIG bruise after all the pushing and tugging (of about 30mins! can you believe that? The doctor told me that this was the longest she had ever taken to remove an implant- boy, she (the doctor, not the patient) did look traumatic afterwards- usually removal is just a straight forward less than 10mins business). I told the patient to take paracetamol asap coz I just know it's gonna hurt after the local anaesthetics wear off.

That's it: NO IMPLANON FOR ME. EVER!

She's a fucking idiot!

...said my consultant.

That was for a patient with a history of PE on 7500units of heparin daily. Now you wonder why am I talking about the heparin-shit when I'm actually doing O&G placement. Well, it went like this. She was one of the patients we (my consultant and I) saw in a gynae clinic. She was asking for termination of pregnancy and I have to say I agreed with him about this (his statement, not the decision to terminate the pregnancy; its her choice at the end of the day). She's just plain stupid.

She had an abortion before in which afterwards she developed DVT that led to PE with all those thrombolysis business. She was put on Heparin from there onwards and was given strict instruction regarding contraceptive and DVT preventive measures.

This current (unfortunate) fetus is now 10 weeks. And she decided to have a termination just because of a slight argument she had with her mother-in-law. She is only 24 and has a son aged 2y-0.

She was slightly overweight. And she still SMOKE!!!! (with no intention to stop at all) You don't need to read medicine to know that smoking is dangerous (but if you were, you will know that smoking is one of the predisposing factors for DVT and well know that a patient with history of PE will be more at risk than other individual in the population anyway!)

And there she was: sitting right in front of me asking for yet another evacuation! (Editor's Note: So many exclamation marks!!) Did she not learn anything from the previous incident? I was shocked with her obliviousness to the degree of her problem (esp the smoking part with PE and she was pregnant, duh!!!) and my consultant was furious!!!

We left the consultation room to go to the doctors' room (to make a booking for an in-patient bed). That was when my consultant said "She's fucking idiot" and cornered me and asked "Do you smoke?" (with frowned forehead and all) (Ed: He could have been more dramatic if he were to pull your shirt's collar, but he didn't.)

She was arranged to have mifepristone the following weekend (Saturday) and stay as in-patient on sunday night, so the next medication (misoprostol) can be given under close supervision. Dual medication was indicated because success rate for complete abortion is higher with both. Plus she was already 10weeks in. The in-patient admission was indicated as safety measure, just in case she bleed after the misoprostol due to long term anticoagulation (high dose).

I have a feeling that she wont live for long. Coz she is utterly stupid! Smoking 10-20 a day with a history of PE/DVT! She also had two separate DSHs (that's deliberate self harm for you who don't know). I mean come on, would you NOT give a fuck about contraception when you well know that you are at very high risk of having complication(s) if you want the UNWANTED pregnancy to be terminated. I seriously dont know how her mind works.

I've been very lazy this weekend

....despite a strong wish of doing multiple tasks.

On Friday, I decided not to go to BIGCITY as I needed to sort out few personal things here in smallcity. However in the last 36hours, for at least 20hours I was either asleep (shocking!) or watching tv. Very counter productive! Biggest regret: not going to BIGCITY (rather than not completing my supposed tasks).

OK. Lets now put on our imaginary hat and look into what could have happen this weekend.
FRIDAY EVENING: Get to train station as soon as the afternoon lecture finish. Dont want to stay in (super annoyingly) wet smallcity. Take a (of almost an hour) train heading to BIGCITY.
FRIDAY NIGHT: Dinner with ex-housemates in an oriental restaurant downtown. Will order some sort of japanese ramen. Followed by small party at a bar in town. I prefer somewhere slightly less crowded and quieter, but this is very unlikely in BIGCITY!
SATURDAY MORNING: Window shopping (which I reckon gonna end up in real end-of-season sale shopping) with a good friend of mine who is a fashionista (wannabe or not- let she decide it herself as I dont want to be judgmental) and a lot of coffees in between (Caffe Nero and Starbucks). Any excuse babe!
SATURDAY AFTERNOON: Quick bite at Subway (possibly meatball) then meeting up with another friend (a he, ahem!) We will watch a movie (streaming from internet). He will probably like this romantic-thriller movie. The movie is rather long (~2hrs) but in the end everything is so sweet! Meanwhile, dinner will be cooked in between scenes. I wont lift a finger though. He will do everything. HAHA. Pasta with a lot of cheese for dinner. I'm not fuss about what pasta being served, as long as buffalo mozzarella is included in copious amount!
SATURDAY NIGHT: I made a promise to another friend (also a he) to meet him for a late night movie. I want to watch "Sweeney Todd" but its not out yet! Boo! So we will watch "I Am legend" instead. I fancy this guy and he knows it. BAD! (Editor's Note: So there you go! p53, dont you think he's gay as he is not attracted to you for even a bit?)
SUNDAY MORNING: Music lesson from an excellent guitarist. Well, not real a guitarist as in a guitarist from band but good enough to pass on his skill to others. I could easily fall for this man! Seriously. Charming, fit, talented what else that I would ask for?
SUNDAY AFTERNOON: Lunch with a couple of very very good girlfriends. Gossiping. Bitching (that's just me bitching as both of them are super nice and they wont slag other people). Then we will buy some ingredients for baking (shared interest between three of us). And bake delicious cheesecake!
SUNDAY EVENING: Pack up my stuff (from shopping and of course a third of that cheesecake) getting ready to go back to smallcity. With luck a jawdropping- handsome man will sit next to me on the train journey.
SUNDAY NIGHT: I will watch TV all night even if no one cares to join me. Skinny cow will. I will sort out the combination of formal attire for the whole week (and ironing them, hate it!).

I think that pretty much sums up my ideal weekend. Of course its gonna be better if I have a boyfriend, but at the moment I'm really not bothered. With a steady boyfriend, somehow, a girl's life will be mainly centered on this one guy. Why limit yourself to just one when you can have many? haha. (Ed: p53 is loyal and remains monogamous(!) when she's in a relationship. Fact!)
PS: Of course I do not forget my gay best friend. He is welcomed to join me and skinny cow on Sunday night.

Weekend came early this week!

Yeahaa!
Thursday A.M. theatre list was cancelled. And Thursday afternoon is a free slot in my (hectic?) timetable anyway! So a full day of nothingness! Yeay! I should really do some PBL work (from last week and this week). Boo. And I need to do some reading for my grand project (commencing next May!). Am I bothered? (in Lauren Cooper's tone). Not the slightest. HA!

What I did was: slept in until it was way past the midday.
Then I baked.
Then I went to gym.
Then I went to a little gathering with some friends.
And ate a lot.

And tomorrow, I'm gonna miss at least half of the morning clinic as I have a personal matter to attend to. In the afternoon I will not attend all the lectures. Me and my clinical partner had selectively chose to go to ONE lecture in BASE HOSPITAL and ignore the other two (held in SISTER HOSPITAL which is half an hour drive from BASE HOSPITAL) just because the timing is ridiculous. They are all back-to-back sessions but all in different locations.
Plain stupid.

I will do as I please. Logistically and logically.
Weekend does come early for me.

Post Exam and Post Coital Bleeding

Good Evening to all readers (ahem),

I'm glad to tell you guys that the exam was fortunately easy! Yeay!
The exam was held in the BIGCITY (main university area) and my seat was right in the middle of a big hall with tall stained glass windows. Since the weather was nice (read: sun was out!), my mood was all bright and relaxed while answering the questions.

When the exam finished, I remembered giggling with a good friend who sat in front of me. Amidst everyone trying to get to the hall entrance, we laughed and laughed, like we were in hypomanic state. Loudly and dramatically. Like we didn't care about anything else in the world. Didn't know what has caught us then. Boy, I felt good afterwards.

Then I went out for a dinner with 13 people. Nice food. Amazing gossips. Arrived back at home just in time for CSI. Had some skinny cow ice cream which was heavenly!

And today, I had a full day.
No of patients interviewed: 6
No of Ultrasound Scans observed: 2
No of cases presented: 3
No of doctors I worked with: 3
No of venepuncture done: 2
No of speculum done: 1 Yeay!

Cases include: Recurrent Spontaneous Miscarriages, Endometrial Cancer, Ectopic Pregnancy, Post Menopause Bleeding, Menorrhagia, Polycystic Ovary Syndrome (PCOS), Post Coital Bleeding and Coil (of 16 years!) Removal. And of course normal cases.

Bril! I'm liking this attachment more and more.
p53 x
PS: One of the doctors sounds like BORAT. Seriously. Whenever he talks I have to constantly remind myself not to laugh. He's really into teaching.

Week One Grand Round

Woo. I managed to go through my first week in Obs and Gynae (O&G) without missing any session. How good am I? -considering all morning sessions start at 8.30am- which is a big scam as first patient is usually scheduled at 9.00am. Which means half an hour of useless waiting. I am not gonna go in for half eight anymore.

For many nights I went to sleep dreading of waking up. It was obviously difficult for me to get out of bed. Even with 3 alarms (and snoozing each of them for about 2-3 times), I still need HM#2 to wake me up for the final round. And that is usually 10mins before I have to leave. Talk about breakfast on the move, I eat everything while standing/walking. Surely that cant be good for my digestion.

Anyways, here are some snippets from my first week in O&G.

In the morning antenatal clinic, I saw many patients with interesting condition. Talking to few of my colleagues afterwards, I found out that their antenatal clinic was rather boring as most of the patients are normal. Not that I'm wishing for abnormal patients but seeing complicated cases is way more exciting! I saw and talked to:-
i) a patient with hyperemesis gravidum. Poor girl, she's only 19.
ii) an Asian patient with two stillbirths and a miscarriage, now in her 4th pregnancy. On further questioning, she is actually married to her first cousin. Genetic problem due to consanguinity anyone?
iii) HIV +ve patient (African) who came in to book for her elective Caesarean section. I asked why as part of Hx taking, she answered because consultant said so. It was such a complicated matter, confidentially and all. She did not mention even once (in my presence) the fact that she is HIV. Her blood result was not available on the system and the midwife that I'm shadowing had to put a call through to the GUM clinic. But GUM clinic couldnt give her the result without patient's consent. HIV +ve patient are advised to have Ceasarean section to reduce chance of vertical transmission to the baby. Mental note: read about viral load (CD4+) and write a reflective piece for this.
iv) an Asian patient with Hx of two small babies (low birth weight). Now the same thing is happening to her 3rd pregnancy. IUGR I was told.

I assisted in Gynae Theatre. Yeay! Most interesting patient on the theatre list was a 17y-o girl who is in her second trimester with 20cm ovarian cyst. Bloody hell. When the cyst was taken out, there was a collective awe from me, the anaesthetist and the nurses. The patient's uterus is still small so after the doctor finished stitching up, her abdomen is flat. So the baby bump that everyone's talking about was actually the cyst.

Gynae OPD was much fun. The sizes of ring pessaries. Dear God!

I like the team I'm attached to.

I met up with few people to discuss about my O&G's fear. And they were all very very supportive.

Additional points from Drug Awareness Training session:
i) Fact 6: Alcohol is the most widely abused substance. More mortality and morbidity are associated with alcohol compared to any other substance. Trend of use is becoming worse in teenagers with the average first time for having alcoholic drink reduce down to 6-7year-old. How scary. I've seen a lot of road traffic accidents, broken marriages and child abuse cases associated to alcohol.
ii) Fact 7: Reiki can be used as one of modalities to treat dependency. (Editor's note: p53 thought that it is a complete bollock. What? Channeling good 'chi' to the soul when trying to come off the dependency? wth? NHS should really put their money for better use, she thinks)
iii) Fact 8: Magic mushroom looks like mushroom. Haha. I thought it is just a special name. It is actually legal to possess it. But processing it into secondary form that can be taken is ILLEGAL.
iv) Fact 9: Injecting can be one of the most dangerous ways of taking drugs. Increase risk of infections (locally and systemically) and transmission of diseases (AIDS, Hepatitis).
v) Fact 10: Most dependent patients will try to get their hands on codeine/diazepam/etc from GP by putting the prescribing pressure to GPs by turning up at 5 to 5 on Friday afternoon. Remember that they wont die. Be stern and say if thing turns worse got to the PCT out of hour service.

So there you go!
PS: Have I mention that I have an exam on Tuesday the 15th? Yeah, all this business of attending ungodly-hour-sessions, doing PBL works, seeing various therapies for my phobia PLUS REVISING FOR EXAM. All in one week. Joy! NOT!

Vibrator

I was in gynae OPD clinic this afternoon when a patient came in with a c/o painful clitoris. My registrar tried to give her general standard advices/explanation. Later when she left, the registrar look at me and said:
"What I really wanted to tell her was-> use vibrator not your fingers!"
*candidate for statement of the year*

Smoking Speed

Yeah, speed.
a.k.a Amphetamine.

I never knew that Amphetamine can boost ones energy level and improve self-confident. Really it can! It is a stimulant that act on the central nervous system and increase brain activity. Large proportion of amphetamine users are single mothers with more than one kid under five. Apparently amphetamine makes them energetic and improve self-esteem enabling them to interact more socially with the world. Their house is immaculate (according to the social workers) as they are very quick in doing work. That's where the term speed coined from.

That's fact number one that I'd gathered from the Drug Awareness Training session held at my GP surgery today. The training was organized by the Drug and Alcohol Action Team of the local PCT for surgery's staff. It was brilliant. There were various street drugs on display in their physical form (cocaine in block, powdery cocaine, Ecstasy pills, marijuana dried leaves) together with the different methods of taking them (small spoon for heating, rolls of filter paper for snorting, syringes for injection). I think that's the closest that I'll ever get to the drugs. Seeing it. I will never try any drug experimentally, take it recreationally or hook onto it dependently.

Fact two: One will feel like being enclosed in bubble wrap when taking heroin. Feeling safe and protected from everything. No pain at all.

Fact three: Nurofen Plus is one of the new emerging culprit. Why oh why? Half, literally half, of the Nurofen Plus tablet is actually codeine and the other half is paracetamol. Both parts are combined right in the middle during the manufacturing process of the tablet. I was completely dumbfounded by then as I just couldn't believe it. Previously the paracetamol half of the tablet is pink in colour and the codeine half is white. A lot of people knew about this halving secret and there was like a mini 'endemic' of Nurofen abuse. Now the manufacturers change it to both white halves, but codeine is one half still. And I'm not gonna tell which one is which.

Fact four: Cannabis is weed is marijuana is puff is hash is ganja is blow. Before this the only other word I know that people use to describe cannabis is: DOPE.

Fact five: The most common combination of multiple drug abuse is Crack + Heroin. Crack is cocaine that can be smoked. Crack is a stimulant too. Once the effects of crack fades one will feel like a total shit (withdrawal-kind of shit). So they will take heroin to help ease the 'withdrawal'. Heroin acts as a cushion more or less. And before they know it, they are already addicted to two different but equally dangerous substances. Shame!!!

There are lot more points that I gathered during the two hours slot. But I haven't got time to type it all tonight. I have to do my PBL. I will continue in the next post.
Loves, p53 xxx

Shredder and Patient Confidentiality

I wish I have a shredder. Not a funky laser electronic one, a simple hand-operated shredder would be just as good. It was a total pain for me when I tried to get rid of my used papers. I wanted to recycle them (me being very environmental friendly) and was very concerned of the informations on them (part of my conscience and ethical-self) and ever so worried about identity theft.

The papers are
i) printed out materials from the previous semester
ii) loads of patients' info (inc top-secret info of patients in the psychiatric unit)
iii) bank statements and other financially related infos (like receipts with cards no# on it)
iv) magazines and new papers

I tore the papers with patients' information into very small pieces. So small that even if anyone (stupid enough to spend time to) try to piece them together again like pieces of puzzles, the chance of getting it right will be almost zero. And it took me ages to that.

My housemates asked why bother? I am very particular about patient's confidentiality. Most of my patients will be labelled as Mr. XY or Mrs XX in my notes taken during history taking.

Fact: it is very difficult trying not to talk about patients when you are living with 4 other medics. Patients are just too interesting, probably the hottest topic at dinner table. I'd imagine non-medics will almost certainly gag with the glorified descriptions of vagina tear and episiotomy when having dinner, but no, the topic remains popular in this household. 'Any fishy smelling vaginas today, eh?'

I do that (gossip about patients, not having the fishy smelling vagina, for God sake!) sometimes although I try very hard not to talk about patients. When there is a very exciting case that I HAVE to tell everyone about, I will try to describe the case in a reflective kind of details. For example: "I interviewed a patient with multiple personality disorder this morning- She is a complete nut! She gave two answers for all the MMSE's questions. I will definitely write a reflective piece about her noting the points that I had to interview her in a very sensitive way, asking open questions to encourage her to talk more about her alter ego."

ok, back to the shredder matter, yeah, patients confidentiality is an issue that should not be taken lightly. Students should develop a habit of ethical disposable of papers and carry on doing this for life. Once my psychiatric consultant (the one i'm attached to, not that I'm seeing one- even if I'm seeing one no one will know about it- PATIENT CONFIDENTIALITY!) asked me about the little note book that I had for my attachment. There are infos about at least 40 psychiatric patients in that book with very detailed personal infos -active presentation, suicidal ideation, sexual orientation, descriptions of delusional ideas- of patients. I burned it after I completed the Pscyh attachment.

A patient with a persecutory delusion asked me 'are you spying on me?' as I kept on jotting down in that little note book during interview. To which I answered no. He then asked me what's gonna happen to all the infos in there. I was startled. If I remember correctly I said: Ooo... don't worry I'm a very private person so I keep everything to myself including this book. After that interview, I make every effort that I can to ensure I keep patients' confidentiality.

Including tearing up pages and pages of papers manually.
Not the hardest job in the world but it takes a lot of time.
Anyone would like to give me a shredder?

Is it 2008 already?

Gosh, it really is 2008 already. Ready or not ready, it's already 2008. [pun intended] (Editor's Note: p53 like to amuse herself by saying thing like that. What a weirdo!) Editor, please be nice with me- it's only the first day of 2008.

I swear to God that this is the most boring new year that I have ever had. Completely dumbfounded by the sheer lack of interestingness in my life right now. Last night I watched the countdown on TV alone. Today I watched CSI alone. Basically I've been watching TV alone all day long since like before Christmas (minus few days when I went to BIG CITY for shopping). Imagine that. No, don't even imagine that, it is just too PAINFUL. And I swear to God that I will never that level of boredom ever catch me again at any time in future. Ever!

Class gonna start pretty soon (tomorrow? yeah it starts tomorrow) and all I will hear from most of my dear friends would be "what I did in Gran Canaria", "look at this tan I got from Morocco", "do you want to see the photos i've taken on my phone when I snowboard in the Alps". Oh, puhlezz.. Dear God, grant me strength. I fucking hate it. I don't mind the fact that they are all lucky enough to have vacations all over the world, I did it myself periodically, but this time around I stupidly didn't plan anything for my winter break. Hence, I had to stay in SmallCity all the fecking time. Pure torture!

Even though, all my housemates are back at home (from their hometown), the house is eerily quiet. I am the only one singing. I am the only one in the living room watching tv. I am the only one in kitchen making cups and cups of brew. Am I the only one alive here?

It seems that everyone just doesn't give a shit to anybody else (read: me!!!) in this house. HM#1 prefers to watch tv in her room, rather than with me in the living room. (What happens to the good old time of watching thriller like CSI together; trying to guess the next scene? Its just a simple thing, but it is one of the things I love.) HM#2 didn't even lift up her head (from her computer) when I entered her room to talk to her. She even said: Not tonight!! when I tried to show her a rather interesting song clip from youtube.com. (We used to exchange links for interesting clips/songs/website of artists humiliating themselves. No more of that. She sounded like she had enough of me.) HM#3 just stayed in her room --smoking. She tried to make small talk with me, and vice versa. Which is not happening as she is always eager to get back to her room, for you know why...

I feel absolutely lonely right now. All housemates are off-limit as they are just not interested to do social things anymore. All my best friends are away from UK. My friends from BIGCITY will not come and visit me in SmallCity. Simply because there's nothing to do here. I was on the phone for more than hour to my best gay friend. He managed to cheer me up just by listening to me yapping. And with that, I'm certain that I'm super duper lonely as I usually limit 5-10mins to a phone call. (I call him like once in 2 days and meet him every other day anyways). Now, imagine how lonely that was!!

I think my personality is not suited to live in time like this. I will actually die if I loss all social contacts. Well, probably not die, but turn nuts definitely! Just let me sleep and wake me up when the winter is over. Winter has somehow affects alot of people around me (turning them more sombre than ever) and I can't tolerate that. Gosh.

Let make prayers for this new year.
i) O dear God, give me more chance to make loads of new friends.
ii) O dear God, give me opportunity (and funding somehow, somewhere) to go travel the world.
iii) O dear God, cheer up all my friends.
iv) O dear God, improve my relationship with others.
v) O dear God, give me signs. About love. About true love. About conscience. Guide me.
vi) O dear God, ease my journey in this medical school.