Cars

I saw a Nissan 350Z on my way to hospital today. It was parked on the curb, looking majestic. Haa. I circled the car twice. AMAZING. I remember now WHY I fell in love with it the first time I saw it. (Brisbane-2006). The car is extremely beautiful, in every way. Trust me.

This car is also known as the "Fairlady". Yeah- indeed the fairest of them all. Its interior is absolutely smashing. Leather seat with one of the coolest looking dashboard. If I ever gonna have one, I'll have the perfect silver one! I wonder how much the one with basic specifications gonna cost. This pretty car will suit the pretty me just perfectly!

Then, I saw few Alfa Romeos (147 series and the classic ol' GT) passed by. Good engine and good built. Impressive interiors. However, Alfa Romeo logo right in the middle of the front bonnet just make the exterior looks asymmetry- as the plat no# has to be shifted to the right. (Pictured here is a very handsome looking Alfa Spider. Looks damn beautiful -but the minute the plat no# comes into picture- the pretty image is distorted) Boo. I want my things to be symmetry.

Editor's Note: (And hell yea- I'm my own editor!) To be honest, once you are inside the car, you cant see it. Who give a shit about the position of the plat no# anyways? All you have to do is drive, knowing that your car is all shiny and posh.

PS: I met MY (previous, i know) consultant in his Alfa Romeo Spider when I passed in front of the obs&gynae unit. Missing him already. Haha. His final words: when in doubt, wear heels!

PPS: or should I get the Roadster?

Updates

Dear readers,

Sorry for the lack of entries. I have been relatively busy with O&G, this being my last week there. Cramming in as much clinical experience as I could in my final week here. That mean I attended every single clinic albeit being late for some due to (not un-fore-seen events of) oversleeping. (shocking?!)

There was a mock OSCE (later referred as Mosce) on Thursday organized by the Registrars. I was like: Shit! I hardly know anything (in term of acting in front of examiners, just yet: I mean come on, OSCE is all about acting isn't it?). I am fine talking/dealing with patients in clinics and wards, but certainly not at all prepared for an assessment.

Indeed, I did quite good for my standard. haha. Me being super nervous in my first station (as usual) and then went along rather swiftly through the rest of the Mosce. Feedback session at the end of the Mosce revealed good level of medical knowledge but should have improve in term of controlling pace of talking (I talk very fast when I'm nervous) and getting the techniques of doing the skills methodically.

Fair enough. This should get me cracking for the real one! (In April if I remember correctly)

Then MY consultant mentioned that one of the registrars said that I performed well in her station. Me and my wit! ha! So that helped. He said "I know you, you're a fast thinker. Quick and have your own wits. But you cant solely depend on that alone. You've got great personality and appear brilliant in front of the patients and get along well with the team. Remember this! I want a clinician who is very composed, not someone who is anxious because I don't want my patients to be scared to hell by my junior doctors."

Yadayadayada. Well. I just can't help it, my facial expression changes so dramatically depending on the cues given by the examiners. I was in fact only slightly nervous in the stations, but nooooo my face gave me away. BOOO!

"I can see you becoming a great clinician in whichever specialty your choose to do"
--> now, that coming from the most gruesome, tough Foundation Year Director of this hospital, surely IS something.

Good.

The registrar who did the first station dragged me along with her to see all her antenatal patients. She was surprise to see that I was all fine, interacted well with the real life patients and got all my techniques correct. See! I can do it after all. She advised taking yoga to improve the self-control. Especially during stressful times. Ok, note taken there.

Then I bid goodbye to both of them. Definitely gonna miss MY consultant and all the registrars. Plus the SHO who I just starting to get to know. So in short, O&G is amazing! I havent learn much from MY consultant (he only ever taught me 2 things: infertility and menopause)

On a different note:
i) I have been quite active this week. Rockclimbing twice. Tried bouldering as well. Body combat. Gym and a lot of running outdoors too.
ii) I've put on 3kg from (almost) a week worth of Italian foods -making my total weight 44kg. Yippee! Another kilo before I can donating blood. Target on hold.
iii) I've started planning for my grand Europe tour. AMAZING!!! Just by looking at the proposed map, I was all excited. (I still need to plan my elective.)
iv) My blog hopping habit is becoming worse. I can sit in front of computer and do the random blog hopping (fashion and celebs gossip blogs especially) for hours. ARGGGGHHH!!!
v) Result of Jan progress test came out. I was fine. lalalala.

So, that are highlights from this week. Personally, I have changed. Am a different person now, though not completely. This O&G placement has not only been a good learning experience but also part of my journey to find myself. Emotionally challenged at some points. Conflicts within myself. Confronting my fear head-on. Standing for what I believe. Receiving advises along the way by those who I respect and trust. Gosh. Sotto hohoende!!!

Next week: Paeds--> bring it on!!

weekend whining

i) Whats the point of having a police-on-horse squad for? Nothing. They go slower than me walking. They go around and around in circle (in supposedly high risk area). Rather than providing amusement to little kids and chance to stride around town in style to the workforce, I think the whole squad is of no practical use.

ii) Seen at a local supermarket, a lady with trolley at the checkout counter with just a 50ml bottle of vitamin. The trolley can probably fit in 4 boxes of 30 cans of Cokes. Easily. Why bother having a trolley for just an item? Too weak? You will need more than just a bottle of vitamin to get stronger, my dear. (Pushing trolley i reckon will consume a lot more energy rather than carrying any single item in hands. With cumulative force downward + gravity, the energy needed will surely be more than carrying the item)

iii) Have a look at the TV listings for the usual 5 channels (BBC1, BBC2, ITV1, Channel 4 and FIVE) for Saturday afternoon. Boring boring boring.

**** notes added on Sunday****

iv) Seen on "Something for the Weekend" on BBC2, one of the guests prepared a cocktail at 10 in the morning! Cocktail with gin and vodka. This cant be right! Kids are watching. And is that normal for Britons to wake up to a glass of martini? No wonder the "E" in CAGE questionnaire will be taken rather lightly by the population. Whats up with calling the guest a "mixologist"? As in a specialist in mixing up stuff to make a great cocktail. Mixologist my ass!

v) Seen this morning at the park, a family (parents and a young child) walking their dog. My heart goes to the kid, he seems as being treated like the family dog in a sense that he is walking with a strap too. That shouldnt be happening.

vi) A lot of daffodils are seen blooming on the road sides. Yeay! Spring had sprung!

weekend's here

My sleeping habit was at its worst last two weeks. So much so I couldnt recall anything from my studies and I now have a lot of things to be settled. Well, Im NOT at all worried, so why should you. hehe.

Weather had been quite good recently. I played basketball on Wed in the court of a local park instead of going straight to bed after afternoon clinic finished. Then on Thursday I managed to run to and fro the hospital (it was freezing though!) I keep on saying that I will bring my inhaler the next time I run outdoor, but always, the weather had been so nice that I was lulled into believing that I'm gonna be just as fine.

And today I went to Body Combat class at a local leisure centre. Good stuff that was. Total cardio work-up if you do all the steps at increase intensity. Truly enjoyed myself there. The new steps kinda difficult and I'm sure my ankles gonna hurt tomorrow. Boo. I was unable to do a hardcore push-up; still. And nope, I don't have a crush on the instructor.

Weather permitting, I'm gonna find some time this weekend to:
i) rollerblade
ii) run in the park
iii) play basketball

Weather independent:
i) rock climbing
ii) swimming
iii) run at the gym

Happy weekend everyone. In case you guys are wondering, what did I do on Valentine's day... rest assure: nothing interesting. I don't even have any plan for this weekend either. I'm just happy the way I am right now.

Why does other consultant always pick on me?

yeah, why?

They kinda pick on students of other consultants. I think. From my personal experience, other consultants that I have worked with didn't seem impressed me asking a lot of questions and not knowing half of the stuff. MY consultant never say anything about that.

"So you are MR ******'s student?" asked a gynae consultant today. Rather in a sarcastic manner.
"Yupe!" (I would rather answer it sarcastically too... like.. Hell yeah, I AM student of MR ******!!)

He asked me questions regarding his subject of interest. Few of which I failed terribly to answer, muddling up definition of few things. He speaks with a posh London accent. And joked about medical school doesnt teach us anything these days. Now i understand what MY consultant meant when he said this consultant speak as if he got an orange stuck up his arse.

For all honesty, his subject of interest is my subject of interest too. So despite the continuous questions about figures and statistics, and of course correction for my answers, I managed to stay focus for the 3hours long clinic. For this consultant, I think I should just ignore his quirkiness about having other student in his clinic because he is INDEED a very good consultant. Have to look wayyyyy pass his up front behaviour in order to learn. For our last patient of today's clinic he brought me along into the examination room (instead of the FY1) so that I could see how vulval carcinoma looks like.

That was today, few weeks back when MY consultant was away another one picked on me too by asking me advanced level of anatomy. How the hell I was supposed to know the name of other ligaments in pelvic except for the usual ones like broad and round ligaments? Even my registrar noted that for which afterwards she consoled me for. "take no notice" she said "he likes to questions students especially the ones he just met".

After moderate level of bashing during operations (4 if I remember correctly) I left because it was not doing me any good. I felt completely degraded that day. The registrar backed me up a lot of time in the theatre room and she suggested me to leave as the rest of the operations are the common ones that I have seen before (read: there's no point staying if he's gonna throw insults expecting me to swallow it all). She was right. I left. I think if I stay any longer I would have start replying in a rather retaliating way.

Boo...

PS: In case you guys are wondering how vulval cancer looks like... it is gross. And if I wasnt imagining, this one has got a distinct smell to it.

A patient that made my day!

I have always like the Wednesday Gynae Outpatient clinics. I think its the only time where I can practice history taking and physical examination at my best. No time limit for history taking. And a lot practical stuffs. The registrars are extremely supportive and encouraging. The new SHO of my consultant (for about a week already by now) is friendly but at times very naive. Bless him. He had just come from Paeds and he doesnt even know what CIN is. (It is Cervical Intraepithelial Neoplasia for you guys out there who doesnt know what it was)

One of the patients I saw in OPD today was a lovely lady requesting for hysterectomy. She's only 44 and is already with many symptoms of pre-menopause. She had endometrial ablation few years ago for her menorrhagia and now it seems like her menorrhagia had make a come back too.

Well, at least that whats on surface.

As I built better rapport with her, she offered me more infos regarding how has all these affected her. Her intimate relationship with her husband has not been so good - terrible mood swings and reduce libido. She is under a lot of stress- full time carer for her mom, holding down two jobs at the same time with two young volatile sons at home.

I felt for her when she said its her family that asked for her to see a doctor regarding her problems. They just think that now her mood swings are getting out of hands. I know she is trying very hard to cope with everything thats happening in her life right now. She is tired most the times but keeps her spirit high by reminding herself that she need to be strong. Otherwise the whole family will collapse.

Imagine the burden that she has to shoulder. Alone.

She fell out with her daughter (18 y-o) and her employee has recently started to question her ability to work her post (limb oedema up to her ankles- fluid retention as part of premenopausal syndrome).

We chatted casually all throughout. Thank God she can still see the brighter side. She is funny in nature. Im sure all these current problems she's having must have tone her down a bit. Or else, she must be such a happy middle aged woman, I think. We had a laugh about few things towards the end of the history taking (you know how one joke leads to another). And she said: "Gosh, that was good laugh. I haven't feel as good as this for a LONG time"

Awww... I just feel like I wanted to hug her at that time. I said: "I'm glad that you felt that way." I truly am. With that, I was all smiles. She really made my day.

Then when I did the speculum and vaginal swabs on her, she again made elated. (sounds wrong, I know, but in a good doctor-patient relationship) She complimented me on my technique of performing the whole thing by saying that I was much better (no even the slightest feeling of discomfort) than most people that had done it on her. Wooohooo..

My registrar said then: "Medical students are reeeeallllllly good these days." And winked at me. How cool is that? Ice cool!

Im grateful to have the chance to know such patient.

Its getting out of control!!!

O dear, its getting out of control! My sleep it is.
In the last week or so, I must have sleep on average 12hours per day.
And this has created a mountain of unfinished works.

I got nothing to blame it on.
Weather is getting nicer and nicer by day. So no more Seasonal Affective Disorder.
I can exercise again since my ankles are now OK. I could have gone to gym in the late afternoon instead of hibernating underneath my duvet.
I havent been doing any night shifts. So, I dont quite understand it myself the tiredness and the extreme call of sleeping that I've been having since the last 10 days.

Even when I went to BIGCITY, shopping with Fashion Guru started quite late in the afternoon. All because I refused to wake up in the morning. She was well pissed off as obviously the earlier we are out, the more shops we can visit. Just like an old saying: Early birds catch the worms.

I keep on saying "I don't do morning!" Now, it becomes apparent that I don't do morning simply because I can't. More often than not I will either be late for or miss my appointment altogether. In the last week alone, I was late for theatre, antenatal clinic, PBL, shopping, lunch (which is on Sunday's midday --> way past the morning time), gym, movies and dinners.

How awful!

Waking up late is one thing, sleeping early is the other. I'm talking about 7pm early. Pure waste of time even before accounting for afternoon siestas. Its like I choose to sleep than doing any other things. If I didnt even do my PBL work, whats the odd of me writing down things for this blog. None. Ai.

Hi ya im p53. Im a sleepaholic!

You should wear a pencil skirt....

...and heels.

With your figure, I think you'll look good in it. Get a good one from Jigsaw or Wallis.

Me: Surely its gonna be difficult to find one that will fit me nicely. They hardly have any size 4 left for skirts.

Yeah.. because you're so thin. The average size here in UK is 14-16. Bloody fat girls. You don't know how many girls are dying to be your size.

But... you got no bums... like my wife. (Editor's Note: How dare him saying things like that!) Let me tell you what you can do. Buy designer's jeans. They'll look perfect on you.

Me: Designer's jeans?!! I'm just a student, how can I ever afford one?

Yeah... its bloody expensive, still costs about 60 quids in sale but trust me its all gonna worth it in the long run. Girls with no bums need something nice fitting, good cutting and all. Do you like wearing jeans?

Me: Yeah..

Jeans are originally made for men. So that's why you have to be very careful in choosing one. If you wear a pair of jeans that doesn't fit you well, you are not gonna look very pretty, aren't you?

Me: A-hmm..

Wear it with heels. Killer heels. No less than 3 inches.

Me: Crazy!

(pause for a bit) Yeah... Stilettos and pencil skirts. I'm sure every guy will be after you. You're already very tall. How tall are you?

Me: 169cm

What's that in feet and inches?

Me: About 5'7"

That's pretty tall. Hmm.. long legs. Wear nice crisp pencil skirt to show them off.

Me: haha

Then wear you hair in...urmm.. that things girl always do... you know... bun thing.. no.. the pony tail thingy (while demonstrating to me how it looks plus pouting his lips to imitate how a girl looks like).

I promise you any guys will be... like... WOW! Fuck!

**All this are verbatim quotes from a conversation I had with my consultant. It has never occur to me that I am gonna receive fashion advices from a male consultant**

Highlights of my labour week! (and tips too)

(Editor's note: Labour week is the week when medical students are let loose in the Delivery Suite. About 2-3 students at one time. Shadowing midwifes most of the time, but also assisting in theatre and putting on nappies!)

1. I saw 3 LSCS (Lower Segment Ceasarean Section). Unremarkable. The sections were quick but the babies were very poorly. And I saw 2 normal vaginal deliveries, which took ages.

2. 1 baby didnt cry after 1 hour and the Neonatal Team came crashing. It turns out that she has idiopathic pulmonary hypertension. Gosh.

3. I was particularly keen on knowing what's happening on the baby (refer no.2) so I stood close to Neonatal Team. My Obstetric registrar summoned me to get closer to the operation table where the mother was being stitched-up.

Registrar: Why are you standing so far away?
Me: Hmm..
SHO: (jumping in) She's probably afraid of you asking her anatomy questions!
All three: Hehehe.
Me: No, I'm not actually. I am just looking at the baby (who was resuscitated at that particular moment).
Registrar: What is this? (pointing to something glaringly obvious, and smiling!)
Me: (I knew she was just kidding) Hmm... that's a tough one! I think... hmmm.... Uterus?
SHO: Good girl. Now tell us the layers that we have to cut through to get to the baby.
Me: Easy. (And I proceeded naming all the layers with success. I was asked the same question the day before).

4. If you're doing night shift, please sit down at every chance that you have. Sitting down reduces the energy usage. I was completely shattered by 3am on the second night (in a row!)

5. Why people scream (and swear in some) so much? Back home there was hardly any sound. Yeah, yeah, its painful. But hey!

6. These days pregnant ladies are asking for pain relief earlier and earlier. It's like: on admission: "give me morphine now!" the 10 min later, " I want an epi!!!" (of course, screaming with their requests). Is everyone pain-intolerance?

7. Pre-eclampsia patients can deteriorate very fast. One minute they are fine (with just proteinuria and high BP), one minute later they are being rushed into the theatre!

8. Midwifes gossip a lot. Seriously a lot.

9. 5am toast is the best thing ever!

10. Placenta is possibly the most gross thing in the world ever! Smelly and mushy!

11. There was a case of ruptured UTERUS!!! CTG tracing was abnormal (prolonged sustained deceleration) but the mom hardly felt anything (she was on epidural). The whole delivery suite became chaotic. Emergency C Section and fortunately the baby is OK.

12. For the first time ever, I came across this capillary thingy used for immediate blood test. It is amazingly cool. Step one: take blood from patient. Step two: fill it in the capillary glass tube. Step three: go to the machine. Step four: insert the tube into the port (then the machine give a flashing green light which is so futuristic.) Step five: Wait for the result. All this in less than 2 minutes.

13. Avoid drinking beverages with caffeine. They are just gonna make you pee a lot. Easier to get dehydrated. Not good for long shift, rite?

14. I was sitting at the midwifes' station when another registrar came and inquired about her previous email sent to my whole PBL group. A list of topics were provided for which we have to choose form and prepare a presentation for Friday teaching. I was like... erkk.. can I do pre-eclampsia one? (having seen 3 complicated case of pre-eclampsia) She mentioned that the topic was taken by someone else already. Bugger! I gave it a thought for a bit (2 seconds really) and said I would do CTG (because she was staring at me waiting for a definite answer) just because i was holding a CTG print-out of a patient. That was on Tuesday afternoon. Then Wed and Thurs I had my night shifts. When do I have time to prepare the slides? (I heard you asked). EXACTLY. I hardly have any free time to prepare the slides. However came Friday, somehow I managed to do a full 15slides presentation plus printed out some interesting CTG of patients in the ward. All in all, it was a feat!

15. It all comes down to who's who. Who's the registrar oncall? Who's the SHO? The midwifes? Is there is any student midwifes? (not good- medical students are kinda neglected when there is/are student midswife(s). I managed to arrange my shifts to those I like. One particular registrar is wicked. I just love her.

PS: It took me ages to type all this out. I'm tired but otherwise still not SLEEPY. Watching tv at the same time. DINGDONG (by Alan Carr!) replaced the usual Friday Night Project. It was equally funny though. Then "the law of the playground" and then TV Heaven Telly Hell. Much fun!