google that

Google and Wikipedia are such an integral part of my life now that I say, "No worries I'll just google/wiki that" at least once a day.

I love Wikipedia. It really is getting me through medschool. Not that I would trust everything in it, but it's just such a convenient starting point for delving further into a concept/subject/point of contention that requires a little more research. Now having said that, Wikipedia's also so awesome (and you know I NEVER use awesome) because I haven't yet found anything I couldn't find on Wikipedia. Even something as obscure as "Erb's point" which was essential to a long-standing (mis)understanding regarding early diastolic murmurs.

On a separate note, I am currently reading up the Soong Sisters (where else but wiki), whose lives I've always wanted to find out more about. "One married for money, another for power, and another for China." When I was growing up, I always fancied myself power-hungry. I still do. But I think, if ever I should marry, it would be for nothing but something silly like love. Marriage is so much trouble, and only something silly could blind us to all its inconveniences!

psychiatry for posterity

2am. I sit in my room, alternately turning the airconditioning on and off. My temperature receptors are extremely sensitive. And my brain. Oh my brain.

I tried recalling the many times this scene has played itself out -- the final few hours before the test, still trying to review those stubborn chapters that just wouldn't stick.

Feels like trying to squeeze the last bits of mayo out of the tube. Onto a sandwich that's already overstuffed with turkey breast and tomato slices. I never eat lettuce. It's like biological styrofoam.

I blog this for posterity's sake. Because this is the last end-of-posting test I'll be taking (not counting Derm, which will happen just 2 weeks before the MBBS in March and which will effectively be my final clinical posting in medical school).

I'm too wired up to come up with an actual psychiatric diagnosis but my mood's elevated I should say, bordering on hypomania. Fortunately I've never suffered from depression in my life, so it's not likely Bipolar II, and I'm not manic enough to be having Bipolar I.

Psychiatry is a pretty abstract subject. The difference between Somatoform Disorders and Conversion/Dissociative disorders being a matter of 'intent'. Neither of which I'd ever want to see, frankly. Both would require a lot of patience.

Psychiatry is also a pretty useful subject -- while it would remain somewhat lower on a list of differentials (not counting a Mood Disorder in which a patient is actively suicidal or manic to a point of self-endangerment), the notes on Organic Psychiatry have provided a good review on an approach to common symptoms like "Confusion in an Eldery Patient".

Pertinent psychiatric conditions apart from the exotic Schizophrenia that I find particularly useful include Perinatal Psychiatry (including Post-partum psychosis), Alocohol Dependence, and Eating Disorders. I don't quite buy the argument for Personality Disorders.

I have Sleep Disorders, Psychiatric Emergencies, Psychotherapy, Behavioral Therapy and Pharmacotherapy to review. Hmn.

bonsai

Psych test on Friday. It sucks but well it's gotta be done and will soon be over. Shit I wish I were more into it.

I realize how much learning is dependent on personal interest. But having said that, interest can sometimes be inspired by a good teacher.

People say sometimes, it takes just one inspirational practitioner to make your decision with regards to a choice of specialty. Though having looked at my collection of logbooks from all the various postings I've had through medschool (can't believe we've almost done the whole round!), I have yet to be convinced. My interest in O&G stems from my long-abiding interest in Women's Health, not because I had inspiring tutors. But having said that, I've found myself drawn very much to Internal Medicine as well, and that again is based purely on personal interest. What about Surgery? Surgery is not especially fun for students, because we really don't get down and dirty at all, but I've met classmates who're surgery obsessed and I'm definitely not into it that way. As regards Surgery, I remain ambivalent.

Specialties aside, I've embarked on this train of thought because while I remain very hesitant in saying "I love Neurology", I drag my sorry arse down to clerk patients on weekends and attend clinics on weekday afternoons despite having a Psych test (which is incredibly challenging by the way) looming 1.5 days away because of the excellent teaching. I was never all that averse to Neurology, but because of my prolonged exposure to the subject, as with my prolonged exposure to cardiac murmurs and respiratory medicine, I have come to appreciate it's intricacies and to enjoy it even. "I like Neurology" is as far as I'll go, which is more than I'll ever be able to say for Psych!

Okay it's almost 1am and I've got a whole textbook, 15 sets of notes and random stuff to plough through. Will continue post-Friday.

easy breezy

We belong to you and me...
"The deepest, the most personal, and the most bizarre..." I think if I ever had Alzheimer's, one of the last things I'd forget would be the time we tried making putty out of our erasers in my bathroom. Heeheehee :)

070707

The day we met, my familiar unfamiliar friend, my horoscope said:

"Secretly you want to know what lies at the end of the road before you take the first step. The stars say it's not important to know the exact details about the future -- just trust that it will be there. Now start walking."

It's true though that horoscopes are hocuspocussy bullshit and we should always listen to our smarter selves and not "stars". (God it's so stupid it's almost funny.) I trusted you, took that damned first step, met you more than halfway and look where that left me. Stranded in a place no girl wishes to be, all alone with that familiar unfamiliarity. Strange stranger, estranged.

Figment figment figment.

chi fan le ma?

Sometimes, it takes so little to make someone happy it makes me want to cry.

I met a Mr Kwok this evening, a rather typical uncle one would find in the wards any given day, with some financial difficulty and glad to finally be able to start using his medisave to offset the bills. I spent an hour talking to him (just 10 minutes on history taking because that's all we're allowed in exams), mostly chatter to keep him company. He was delightful, and so willing to be examined I felt almost guilty, thus interspersing my neurological and eye examination with bits of conversation to amuse him. He actually stopped eating his dinner because etiquette demanded he paid attention to the doctors, even though they weren't speaking to him, rather speaking of him in front of him. He looked on, like an adorable mynah hoping to pick on a sparkly bit o' string.

I don't really know how to describe the feeling one gets when at the end of a long, humid somewhat sub-productive day, you feel like you've come home to somebody who needs you and whom you need too. It's nice to know that in some small way, one has helped, albeit in the pursuit of knowledge more than for any other altruistic reason.

I hope he gets his rice tomorrow. He's been living off rice grains drowned in soup.

on alzheimer's disease

"Memory loss is not like loss of land with a rising tide: the last memories to be sunk in the sea of forgetfulness are not earliest or latest, but the deepest, the most personal, and the most bizarre: prime ministers come and go, but for dementing British patients of a certain age, the last name retained is that of Mrs Thatcher. When this name sinks into oblivion ('fame's eternal dumping ground'), often long after that of sovereigns, deities, spouses, and children, one may safely say that the waters have covered the sea."

Strangely touching, almost funny, so beautifully expressed. I love my Oxford Handbook and I wish I could write like that.

nice guys, first

When I say with complete honesty, "Well, I wouldn't mind going out with X. He's really nice!", more often than not my girlfriends think I'm kidding, and with blatant astonishment they unfailingly say, "No way!"

I think "niceness" is pretty darn underrated. After years of wallowing in a Dating Desert and being told over and over, "You're just too choosy!", I think it's time I corrected some misconceptions.

I don't believe I'm selling myself short by saying I seriously wouldn't mind dating somebody nice, who'll understand when I need to be selfish and on my own and whose niceness is so overwhelmingly incomprehensible that it leaves me stunned.

Yes. I would like to be stunned, swept off my feet, in constant awe. And why not by "niceness" or "kindness" or "goodness"? There're few things more valuable. I should know to treasure them, since I have precious little of the abovementioned.

What Do Paeds And Psych Have In Common?

Absolutely Nothing.

Paeds revision postings are woefully inadequate -- we basically have 2 weeks to cram everything in. Not Possible. So what does this mean? Well, I guess the upside of being assigned 14 weeks worth of clinical postings at NUH for M5 means that we get to raid the paeds wards during said period.

I've just started psychomed revision posting, definitely not one of my favorites. Another 2 weeks of evaluating neuroses, psychoses and trying not to catch either. Though if you think about it, it's probably normal to be neurotic because everybody has their own quirks but I think it's definitely not normal to be psychotic (hello, hearing voices?? time to get that checked mate).

Over the weekend, I discovered many auditory pleasures. Well, all of Eason Chan's mandarin hits. He's just phenomenal!!! I love him! As much as Jay Chou :) Esther Fang and Steffy Lim -- we are going for Eason's concert if he has one okay!!! And Judie the Pug is soooo adorable, such a little piglet :) And my brother says baby pugs aren't puppies -- they're PUGLETS! How cute is that?

And yes, I've not forgotten my American Pictures, but I'll do those once I get this stupid case report of "Zoster Ophthalmicus with Complete Ophthalmoplegia" out of the way.