Pancakes

Medical school is like trying to eat five pancakes every morning for breakfast.



Text for the video above:

At the beginning of each course, we’re given a syllabus telling us how we’re going to be graded, the question break-down for each test, and the schedule of lectures each day for the next 4-5 months. Nothing is going to sneak up on you unless you can’t read the print on the page (in which case you’re blind and things sneak up on you all the time).

But it’s sunny outside or snowing outside or Tuesday. Whatever. You’re in medical school to become a doctor, not to be in a classroom (scheduling conflicts here) and you find yourself out on the weekends, maybe catching a movie on the weekday, and so on. You blow off the first week of any course because the material is supposed to be introductory and you certainly blow off the first week after any exam to recuperate. Maybe you take off two weeks if it was especially difficult and draining.

Eventually though, the next exam is closer than the last exam and you have to return to the desk and pretend to be a serious student. The first week back studying, you won’t be as efficient and as familiar with the material as you were leading up to the last test, so there’s some built-in catching up to do. You can’t understand the material taught TODAY because you blew off the introduction, so until you catch up, you keep falling behind. By the time you’re back in your stride the exam is so close you can feel it’s breath on your neck and you still have material to cover on a first pass. Let’s not forget: you haven’t reviewed or committed anything to memory at this point.

It’s now that you understand the truth:Medical school is like trying to eat five pancakes every morning for breakfast.

You know you can do it. A Premed advisory committee endorsed you saying, “He has the stomach for it. He’s committed.” And you prove them all right. Every day you show up with your first-year optimism and your annoying hunger for learning and you clean that plate (just kidding, it’s adorable). But you begin to notice that those pancakes are slowing you down a little each day and the sugar highs and lows are screwing with your sleep. Smart person that you are, you decide to pass on the flapjacks one day. You think to yourself, “Self, I’m going to eat ten pancakes tomorrow so that I don’t have to eat any today.”

But it never stops. Turns out that “self” isn’t the most responsible lender, and before you know it there are 40 pancakes in front of you and your plate needs to be clean by tomorrow. So yeah, at this point it looks impossible. But really, it’s your fault.

In the future, as I like to imagine it, I’ll be in charge of all medical school admissions. The process will be six weeks long and will consist of nothing more than showing up each morning to eat five pancakes, at which point you can then go about whatever you were going to do that day. At the end of the five weeks a few jaded, newly diabetic hopefuls will come to my office and, mixed with both pride and resignation say, “I did it. I finished those goddamn pancakes.”

“Wow,” I’ll say. “That’s very impressive. You must be very proud, and your parents must be very proud. Just one more thing.” They’ll reflexively clutch their stomachs, shifting their girth from one hip onto the next and groan, “What’s that?”

“Regurgitate it.”

I'm very proud of BL (once again)

Subject:	THE RAE RESULTS: MESSAGE FROM THE WARDEN AND THE DEAN FOR RESEARCH
From:	"VP Association"
Date:	Fri, December 19, 2008 11:41 am

THE RAE RESULTS: MESSAGE FROM THE WARDEN AND THE DEAN FOR RESEARCH


Dear Colleagues,


We want to take this opportunity to thank all staff in the School of
Medicine and Dentistry for their marvellous efforts which have propelled
SMD into the top tier of research active medical schools, as announced
yesterday in the RAE results and reported in today's press.


This has contributed to an astonishing ascendancy of Queen Mary in the
league tables. In RAE 2001, QM was 48th in the Times Higher rankings. In
2008, we are now 13th out of 132 universities in the UK, one place
behind Edinburgh In the Guardian rankings we are 11th (the Guardian
does not count two small mono-subject institutions). Across QM as a
whole, Humanities and Social Sciences also performed at a very high
level.


QM belongs to the smaller research intensive 1994 group of universities,
while the 20 larger research intensive universities form the Russell
Group. QM performed better than 12 Russell Group universities,
including Birmingham, Cardiff, Glasgow, Kings, Leeds, Liverpool,
Newcastle, Sheffield, and Southampton.


Detailed comparisons between medical schools are not available at the
moment because different schools entered different units of assessment.


However Dentistry in UoA10 had a brilliant result. Based on quantity of
3* and 4* outputs, we were first equal with Manchester, and when this
was converted to rankings we were 2nd out of 14 UK dental schools.


In other units of assessment the medical school performed incredibly
well. To use the information and rankings published in Times Higher
Education:


UOA2-Cancer, 3rd of 14 submissions in terms of 3* and 4* work, joint
5th overall ahead of Oxford, Imperial, KCL and UCL.


UoA4- Hospital subjects (ICMS), joint 1st with Cambridge and Edinburgh
in terms of 3* and 4* papers, joint 7th overall out of 28 ahead of
Manchester, Newcastle and Southampton.


UoA6- Epidemiology (Wolfson Institute) , 2nd of 21 in terms of 3* and 4*
papers, 3rd overall ahead of Oxford, UCL and Bristol.


UoA7-Health Services Research, joint 5th out of 24 in terms of 3* and
4* papers, joint 7th overall out of 28, 4th overall ahead of Oxford,
UCL and KCL.


UOA9-Psychiatry, joint 10th out of 17 of 3* and 4* papers, 12th
overall.


UoA15- Preclinical and Human Biological Sciences ( WHRI), 3rd in terms
of 3* and 4* papers, 4th overall out of 13 ahead of KCL, Bristol and
Nottingham.


We expect that these results will guarantee Barts and the London School
of Medicine and Dentistry as being ranked one of the top 10 medical
schools in the UK, and with a fair wind, higher than that, in the same
company as Oxford, Cambridge, Imperial and UCL.


Our congratulations and many thanks to all of you who contributed to
this fantastic result.


Best wishes,


Nick Wright

Warden

MOH

Finally, after listening to many stories of NHS, now I want to know what the situations are like back in Malaysia. Found this on MOH website:

"Ministry of Health Malaysia
Strategic Plan
2006 – 2010"


http://www.moh.gov.my/MohPortal/Pelan%20Strategik%20KKM%202006-2010.pdf?action=view&id=102

Cold France!

France was really cold. Over my SSC(assingment/holiday) week went to Blois to visit my brother there, then we went for a daytrip to Paris. It's indeed a beautiful city (more beautiful than London I must say).


I must learn how to speak French. First, so that I can go to France anytime I want (without needing my brother's company to translate for me all the time). All the time I was by myself there (my brother, unlike, still had classes to attend), I was longing to be able to convey my ideas to the locals, and it's rather frustrating that you couldn't do so.

Plus, French gov is looking for more doctors. Expanding my options in my future career. Hehe

Plus, they say, the more languages you can master, the smarter you are!

Barts choir

Yeah, I did it again - singing in THE Royal Albert Hall with the Barts Choir. It's been 1.5 years since I last did it.

Other than 'Towards The Unknown Region' by Vaughan Williams, we also sang 'Carmina Burana' by Carl Orff. One of the movements (songs) in the latter, called "Fortuna Imperatrix Mundi", is very famous because this is used in a lot of epic battle scenes and adverts. There are a lot more movements within Carmina Burana that very enjoyable to listen to - interestingly not many people know that.

I had really wonderful time singing them, especially Carmina Burana. After we finished this very challenging piece, I was VERY elated at the cheers from the audience!

If you still have no idea which song I'm talking about, check this out:



And this is my favourite, the tongue-twister exercise 'In taberna Quando Sumus'. I've included the lyrics for this video (note: drag to 1:13), so have fun trying them out! Somehow this movement is almost like rapping - the classical music way!



In taberna quando sumus
In taberna quando sumus,
non curamus quid sit humus,
sed ad ludum properamus,
cui semper insudamus.

Quid agatur in taberna
ubi nummus est pincerna,
hoc est opus ut queratur, si quid loquar, audiatur (2x)

Quidam ludunt, quidam bibunt,
quidam indiscrete vivunt.
Sed in ludo qui morantur,
ex his quidam denudantur
quidam ibi vestiuntur,
quidam saccis induuntur.
Ibi nullus timet mortemsed, pro Baccho mittunt sortem (2x)

Primo pro nummata vini,
ex hac bibunt libertini;
semel bibunt pro captivis,
post hec bibunt ter pro vivis,
quater pro Christianis cunctis
quinquies pro fidelibus defunctis,
sexies pro sororibus vanis,
septies pro militibus silvanis.

Octies pro fratribus perversis,
nonies pro monachis dispersis,
decies pro navigantibus
undecies pro discordantibus,
duodecies pro penitentibus,
tredecies pro iter agentibus.
Tam pro papa quam
pro regebibunt omnes sine lege.

Bibit hera, bibit herus,
bibit miles, bibit clerus,
bibit ille, bibit illa,
bibit servis cum ancilla,
bibit velox, bibit piger,
bibit albus, bibit niger,
bibit constans, bibit vagus
bibit rudis, bibit magnus.
Bibit pauper et egrotus,
bibit exul et ignotus,
bibit puer, bibit canus,
bibit presul et decanus,bibit soror,
bibit frater,bibit anus, bibit mater,
bibit ista, bibit ille,
bibunt centum, bibunt mille.

Parum sexcente nummate durant,
cum immoderatebibunt omnes sine meta.
Quamvis bibant mente leta,
sic nos rodunt omnes genteset sic erimus egentes.
Qui nos rodunt confundanturet cum iustis non scribantur.
Io!

And finally some pictures:

o2

Oxygen-Spencer Pidgeon

keep me here for just five minutes now
everything I do, I'll show you how
though I'm sure that it's not possible
one thing I know is this love's unstoppable

come in closer, whisper in my ear
all the words you know I long to hear
I tried to trace your lines just like a map
but in your deep blue eyes I found a trap

show me a sign and I can guarantee
that all the love you bring is safe with me
lonely hearts, they need a helping hand
so be my air and I'll be your oxygen

be my air and I'll be your oxygen

Split in between

Work hard and play hard?

Play hard but work harder?

Work hard but play harder?

Trypanophobia

(yay... I'm blogging again.)

Last week I did one all-night shift out of interest for seeing the situation in the Accidents and Emergency dept in Newham Hospital (because that's when usually the real actions of A&E kick in.) The scenario wasn't as close as I expected to be, like those in ER. It was rather quiet, chilled out night (good for the hospital staff, bad for a student like me). However, it still rather very rewarding night.

The night thought me that I'm no superman, especially in A&E. I couldn't solve everything (if I could, I would have been Dr Gregory House). I took a history from a Thai lady who had majority of the common neurological presenting complaints to a doctor, and it took one hour just to complete the task. Her anxious family members (in total 4 of them being the same small cubicle) were obviously very tired (of waiting for me to finish). Was rather frustrating that I still couldn't give a definite diagnosis at the end of it. I didn't know what she truly has. If I were the doctor, I would have gone all out to get to the bottom of this.... maybe because of my guilt of not knowing enough medicine. I need to learn to cope with insufficiency, being aware that we have our own human limits. That's why medicine would need to have many specialities so that some us would be more knowlegable in one field and less in another.

Just when you thought you are about to give up on yourself, sometimes in life there would be someone that still continues to hope on you. I learnt this, rather humbly, at 5.00am, when this 25 year-old gentleman, Mr NM, a long-standing asthma sufferer was brought in by ambulance for his worsening breathlessness. He was very afraid of needles. I initially told him that I would be able to cannulate him. But after inspecting his veins, which appeared rather small and hard to cannulate on, I said would not want too - never had positive experience with this issue. I told him that I'll one of the nurses to do it. I told him that if I were to do it, it potentially meant having several attempts at cannulating before success, and I didn't to particularly distressed a trypanophobiac like him. To my surprise, he insisted that I gave it a try nonetheless despite all my warnings. And guess what? I succeeded! I could feel that both of us were practically shaking from our own fears and embarrassements of the needle. When all done, we instantly exchanged chains of apologies. I was sorry that I caused him much discomfort; he, for being scared of needles. I must say he had been a very brave man.

Oh yes, and the Thai lady with neuro problems was afraid of cannulaes too. When she saw the cannulae put into her hand, after a doctor examined her, she immediately began to cry. The concerns I digged out of her was that she thought her condition was something very serious (although that was still a matter of debate), that was why she had this cannulae in. When in fact, and this was what I told her, 'cannulae is a common procedure that is given to everyone who comes into the A&E dept'. Being a student, who is already used to whole hospital thing, I sometimes forget that things that are very trivial to me may be something regarded as life-threatening to patients. I guess that's where all the communication skills taught at med school become useful in handling this situation.

(and in conjunction with the release of the new Bond movie sequal: The names' Wilson.... Aaron Wilson.)

Year 3 - a reflection

Tomorrow will be the first day of Year 4 official learning day. Two days of briefing last week gave me some idea of what to expect in this year 4 (damn, I'm actually into the fourth year being a medical student). It feels more challenging in terms of the amount work you have to do than Year 3 and it demands a more mature 'me'. It therefore creates an opportunity for me to reflect on Year 3.

I must say in the first two years of being a medical student, I lack the clear focus, which I then regained in third year. After learning it through the hard way in second year, I improved my approach in studying medicine. However, it took a great amount of time for me to improvise and tailor it into my own style, and hopefully this will improve in Year 4.

First, I would need to improve on my prioritisation skills. I love to do a lot things, other than doing medicine. However, I sometimes made unfair compromise to many things and ended up losing the grip for all the things that I want to in life. I need to learn how prioritise things - 'being effecient is knowing how to do thing wells; being effective is knowing well when things should be done'. That said, this would include procratination. If that superseeds above all, then my priority in life is not right, and that creates a lot unnecessary strains on myself.

Second, I must be able to see to bigger picture more frequently. Last academic year, I was frequently commented by my consultants in all (but one) of my firms that I lack this ability. I lack the skill of thinking of situations hollistically, and I instead just vomit out (silly) answers as soon as the issue is posed towards me. Most of the time, I got the answers wrong, or partially correct. I should have realised by now that medicine is about breadth first, then details. I should be able to categorise 'causes of chest pain' rather than just regurgitating the answers. Besides that, if only I see the big picture of the clubs and societies that I joined, I believed that I could do so much more for the organisations.

Third, explore life more. Get involved with the community more, go traveling, form stronger bonds with friends, not settling for mere monotonocity and do a lot more. Makes life more interesting when you have a lot of interests.

God willing, if I can learn to master these skills, I would grow more.

The Ultimate Cuti-Cuti Sabah Blog Entry

I know this is a long due entry. Having loads of fun back in Malaysia. Unfortunately I had to return to London not long after that. I would have been in Malaysia longer if not for the late notice by the medical school that our term was only going to resume on a Thursday instead of a Monday.

Anyway, here is a quick run through of what else had happened during the holiday!


Kampung full of Kelapa sawit!
I have always loved to go back to Sandakan area, because I have a lot of relatives there. Seeing the green palm-oil tree plantations running in both sides of the road is pretty cool. I bet the villagers can easily be rich because at the moment for 1 tonne of palm oil seed, they are paid RM700+. Imagine if they produce even 10 tonnes, that’s already RM7000 every month. Talking about money growing on trees!

Hanging out with cousins!
Went out clubbing in KK for the first time. I don’t think it’s fair to compare KK to London’s scene (although I like the latter), because the different size and huge difference in the average income of the population. Went out from 8am and came home around 4am. Hoho. Kena ‘sound’ jugalah.

I think to go clubbing as a local earning in ringgit is pretty expensive. 1 glass of alcoholic beverage is already RM15-20, and if you’re the ‘kaki arak’ type, you’ll probably drink at least 5 glasses. Then if you belanja orang lagi, lagilah banyak kau belanja. Easily in one night, RM150 would have been wasted. And if you’re earning the average Malaysian income which is probably around RM1500, that’s already 10% of your income. So, if you want to fit into this kind of lifestyle, you must be either: very rich, very little financial commitments, or … the club belongs to your family.

And otherwise, just met a lot my family members!

The KK outing
Kota Kinabalu city has pretty much changed since I last went home 1.5 years ago. It now has opened several flyovers, avenues and shopping malls. More housing development projects are running too. Beautification of the seaside with the esplanade development project, of what said would be the longest esplanade in Asia, take place(although the stinky smell from the dirty sea is still there). Also the new Airport terminal was opened in the 3rd week of August. It looks a lot like KLIA.

I also noticed how intense the cleanliness campaign happened. DBKK used the HUGE billboards on the main streets of KK telling the people along the line of ‘they are being watched. So, don’t throw your rubbish out of the window of your car, or you would be fine’.

There are couple of food I would miss: the Tuaran mee, teh-c-ping, kaya ball and Yoyo!

Conquered mount Kinabalu!
It proved to be a challenging activity as I struggled with high altitude, thin air and cold weather. But it was worthwhile when I finally reached the top. Must say, it was not the greatest view (very misty). 10 minutes later, it started to rain heavily and I was forced to descend from the top. My gloves were wet. My hands become painful and numb. The wind accelerated this development. The descent felt to be more dangerous as visibility in reduce to 1-2 metres, slippery and steep terrains all over the place. Thank goodness the weather improved and I could actually see the path we actually took during the ascent. Pretty deadly if you didn’t heed the advice of the guides of holding on the ropes tightly.
Went all the way down to the Timpohon Gate (where I first started) on the same after resting few hours at Laban Rata.

And for the next few days, leg muscle sores were inevitable. It was especially painful if you have to bend your knees, e.g. climbing down stairs. But that was pretty good fun!

Island hopping!
15 of us hired a boat to go to Pulau Manukan, Pulau Sapi, and Pulau Mamutik.

Had nice tan. Doiiii….being sooooo westernised. Hoho.

Tip of Borneo!
Never knew Sabah would have a nice place like this

Marriage
3 cousins kahwin

Parents’ 25th anniversary – silver one. Makan-makan at NewYorkNewYork (it’s ok-ish. My food was no longer hot as I waiting for everyone's food to arrive. The waiter should have served all meals together). Then they had a studio photoshoot.

Missed my KK-KL flight!
I was supposed to fly on 22nd. Just didn’t quite understand why I thought it was on 23rd all those times I was in KK. I guessed I was not ready to fly lagi. Well, learnt to be meticulous about my plans in future. I still had to buy a new flight – much, much more expensive. It was indeed, figuratively and literally speaking, a costly lesson.

KL outing!
I don’t really like KL because of its terrible traffic jam and appalling public transport system. I was wishing really hard the public transport would be as efficient and effective as London. Wishful thinking.

I love the shopping malls in KL, though. Beautiful and plenty of options.

Incidents
Sabah's beloved hypermarker, Servay, was burnt to collapse. The very first hypermarkert in Sabah, was burnt due to short circuit that occurred in the stock room. I was quite sad actually with this news because I grew up with this shop, seeing it grew, from a small store to its occupation of the entire lot of the row of building in Bandar Penampang Baru. I would imagine many people would be moved by this unfortunate incident, as evident by the headline it made (twice) for New Sabah Times and Daily Express, the main newspapers in Sabah. Those who lived around Penampang, like myself, went to the ground-zero-site of what once used to be a place of happiness for shoppers. 'Paid' my last respect.

Another story: Saw an accident in KL happening right before my eyes. It involved a bus with a motorcyclist and his passenger. Scary. I should have done something, since I think I have enough medical knowledge to help the victim out. But I didn't, too shocked, probably. I didn't even called the ambulance. Thankfully, the were policemen at that time to handle the situation.