Thursday, December 04, 2014

Letter 715: In Absentia

Today, a wispy layer of sadness fluttered in the air like a silk hankerchief hung out to dry. It was a beautiful day-- despite being woken up with a jolt at 3am when a loud crash of thunder shook the sky, and despite feeling the presence of a 3.3 magnitude earthquake when I was brushing my teeth (although at that time, I had mistaken the rumble for that of a really big truck passing by my house). It wasn't until the deejay announced over the radio that the epicentre of the quake had come from a surrounding neighbourhood that it dawned on me that it could have been worse.

There are always things in life that could have been worse. Moments of near-misses that make us ponder along the lines of "What if I was there 2 seconds later/earlier? What could have happened?" Like this evening, when I was heading home along the highway, and this van kept eating its way into the left lane I was driving into, even though I had already made sure there was no cars wanting to course into that same lane. I even had my indicator lights on for a good 3 seconds before I turned into that lane. Damn van didn't even have its indicator lights on until halfway after his car was in the lane. What's the point? He didn't even seem to notice my big black 4-wheel-drive, which was heading into the same lane as he was. By the time I discovered his intentions, my first instinct was to swerve right, back to the right lane, and narrowly missing the taxi in front of me. I didn't even have time to blare him a sound warning, for had I done that, I would have unfolded 3 possible scenarios, each with a dreadfully bleak outcome for me and my car:

1. I would've crashed into the taxi in front of me;
2. The van would've crashed into me;
3. There would have been a 3-car pile-up.

Fortunately, I managed to get away without damaging anything in the process, and although I was seething inside, I was also actively picturing a parallel universe where perhaps that 2-second window of reflex action would have led to a completely different outcome. Or another universe where I may not even find myself in this situation because I would have taken a longer/shorter time for dinner, or I would not have chosen this day to pick up my dry cleaning on my way home. But if those alternative scenarios did happen, then perhaps in that matrix I could have encountered a different set of problems. I guess all I'm trying to convey, is that things could have been worse.

(I know, since when have I become such an optimist.)

But I digress. This is not why I was sad. I felt glum because there's going to be a big round of good-byes coming up tomorrow, and I am not very good at byes. Tomorrow, we will attend our final lecture, and try out some mock exams, and then everyone will leave, because most of them will have a plane to catch. These are the people whom I knew before, who existed in my not-too-distant past and whom are now flitting into my life again. Then there are the ones whom I have come to know over the last 2 weeks of the course. We always hung out for lunch, have mid-week dinners together, and tried to motivate each other to study. The problem is, we were all from different cities-- not to mention different states-- and after tomorrow, the bonds that bound us like covalent atom pairs will be broken, when we all go our separate ways. All for one and one for... none?

There are many ties that bind. People, places, memories. The threads are fine and delicate, and if you don't look too closely you can pretend they aren't there. But they are there, ethereal like fine gossamer. And every once in a while, when the wind blows in the right direction, there is a gentle tug on the line, and you realise you can never escape.

Good times at Papa Goose, where a 1-hour dinner turned into a 3-hour conversation. 

Sunday, November 30, 2014

Letter 714: Diary of an Existence in Constant Motion

If I could sum up the week, it would be this: terribly taxing but incredibly inspiring.

I've been waking up at 5.30 every morning to drive into the city for my exam preparation course. At 6am, the Monash Freeway is already congested, with traffic halting almost to a complete stop at the more popular exit ramps like Springvale, Blackburn, and Warrigal Road. It takes me an hour to reach my destination-- if I drive smart enough to avoid getting stuck behind slow-moving trucks that have no business hogging the fast lanes.

Parking in the city is a disaster waiting to happen. Carpark ramps are so narrow that it is impossible to maneuver a four-wheel-drive without breaking out in cold sweat. The first day in the carpark, I almost had a mini panic attack as I had to steer my car around the acute angles to get to the claustrophobic ramps. The sigh of relief that came from somewhere deep in my stomach after I managed to exit the carpark without a scratch or dent on my car was so loud that you could hear it all the way across the border to New South Wales. 

I've had lectures every day from 9 till 5-- 45 minutes each with a 10 minute break in between. The lecturers all shared something in common apart from their jobs-- they were top-notch speakers who gave quality talks on the subject they were lecturing on, and they all had a twisted sense of humour. The course was full-on, demanding of time and absolute, unwavering attention, which usually left us with a mixture of awe, inspiration, trepidation, and a splitting headache by the time we walked out of the lecture room. I swear I needed multimodal analgesia after the last lecture on Friday.

The course continues tomorrow for another week, and we were already given a second folder that is just as thick and as heavy as the first one. Bound to it are pages and pages of notes, passages, slides, graphs, equations, and pass year questions. I'm having another headache just thinking about it.

On the other hand, the course has re-united me with an old friend, and opened doors to new ones. The little things that made up for the insane intensity of the course, as I've come to realise, are the ones that center around kinship with other people:

- the nice barista who prepares my coffee every morning
- heading out for ramen with old and new friends for a mid-week dinner
- meeting up with another old friend for breakfast while he was in town
- discovering lunch places along St Kilda Road (the Indonesian restaurant just round the corner from our college is my favourite)
- attending a kid's 2-year-old birthday party and enjoying a barbecue dinner with old and new friends next to the jumping castle: chicken wings, sausages, lamb chops, corn and sweet potatoes never tasted so yummy
- Korean dinner followed by Dairy Bell ice-cream with a high school friend and his wife

This week taught me that no matter how busy our lives are, without the integral connectivity with other human beings, life would have been unimaginably unbearable. So to those who have always stayed in touch whether by phone, messaging services, email, snail mail, Facebook, Instagram, or even leaving comments on this blog, thank you. And I will try my best to reconnect with the world once again, when this whole exam fiasco ends in the ultimate demise of my spirit.

Wednesday, November 05, 2014

Letter 713: Anecdotes on a Spartan Life

Facebook seems like a lifetime ago. When, once, I had spent too many unnecessary hours scrolling through my Newsfeed, clicking the "Like" button on certain pictures and status updates, browsing wonderfully shared pieces of writing and sharing other articles in return, I now have no time for frivolous activities as such. The funny thing is, though, I don't miss it. People have been known to go on "Facebook fasts" (as evident by their status updates-- how about that!), and I wonder if they came out of their fast feeling digitally detoxified to a certain extent? My last activity was almost 4 weeks ago, and although I sometimes have the urge to post ultra-adorable pictures of my dog, I just haven't felt like doing so. The most active I've been lately is posting birthday wishes on Facebook. And I'm quite contented with that. 

The other day, I almost walked 10,000 steps just wanting to get one sheet of paper laminated. That's right. One sheet of paper. First, I approached the theater secretary, who confirmed my suspicions that we didn't have a laminator in theater, so she directed me to the Stores area around the back of the building. Took me a while to find the Stores Manager, who then said to me they could provide stationery but not laminating services, and that I needed to go to Administration. Walked from the back of the building to the front of the building and round the corner to where the newly built hospital wing is, which houses administrative staff in cubicled corners answering phone calls in hushed tones. The pervasive sound in that area has always been the fervent clicking on the keyboards-- all those emails to send, memos to draft and distribute... must be hard work, because no one could tell me if there was a laminator in the Administration area. After circling the area and finding no answers, someone said to try the old Adminstration offices, so I walked back to the bowels of the hospital, making my way to the old offices, only to be told by the girls there that the laminator is housed in Switchboard. At this point in time, I didn't know if I should be mad or laughing, so I did both-- I laughed madly. And people wonder why I don't go to the gym. Shaking my head and suppressing a sigh of frustration, I headed to the Switchboard operator, who eventually confirmed the existence of a laminator. All that walking for one sheet of paper. That night, I tucked into a bucket of KFC without the slightest bit of remorse.

I think it's all the walking. And the long periods of fasting. Some days I feel like I've lost weight, and I'd be craving greasy foodstuff such as pad thai or a good ol' pub burger with chunky fries on the side. I went to the tailor's the other day to get my bridesmaid's dress altered, and had to take 10cm off the bust, the waist and the hem, respectively. Two of my colleagues asked if I'd lost weight, and I said no, I didn't think so. Maybe I'm re-distributing my fat in other places. Damn you cortisol.

I buy books. Lots and lots of books. I just never have time to read them nowadays, although I am continuously deluded by the possibility that I would get to finish at least one new book by the end of this year. It's hard to read a proper book when your choice of reading material is a medical journal when you're in the toilet, or a textbook when you're in the passenger seat of the car. New titles sitting on my shelf since August, some read, but mostly untouched, are:

1) Christopher Hitchens- Arguably
2) Alain de Botton- Religion for Atheists
3) James Franco- Palo Alto
4) Italo Calvino- Invisible Cities
5) Nassim Nicholas Taleb- Antifragile: Things that Gain from Disorder
6) Charles Bukowski- Hot Water Music
7) Anthony Marra- A Constellation of Vital Phenomena
8) Paul Auster- Leviathan
9) Haruki Murakami- Colorless Tsukuru Tazaki and His Years of Pilgrimage
10) Mikhail Bulgakov- The Master and Margarita

The flipside of being so assiduously immersed in my new role is that I have a newfound appreciation for slowing down. Many moons ago, while hurriedly making my way to the labour ward for an epidural, I remember my mentor-- who was strolling 10 steps behind me-- telling me this, "Jun, you walk too fast. When you walk slowly-- like I do-- you'll live on a different plane of existence." At that time I brushed his comments off with a nervous laugh, as I was keen to get on with the epidural. Over time, his words stuck with me, and that was how I started winding down despite my insanely hectic roster. It was probably why I started doing yoga. Yoga came to me one day like an awakening. It is my form of meditation, just like archery is to celebrated author Paulo Coelho. Frankly, I have not mastered the art of sitting still to meditate. Being more of a doer than a thinker, I prefer to be a little bit more active. Yoga provides that perfect balance for me. The most soothing action, I find, is that first act of unrolling my yoga mat on the floor. I try to practice yoga at least 3 days a week after work, and although that is not always possible, it has helped me achieve a sense of inner peace which I did not believe was possible within myself .

Colonoscopies [noun, plural of colonoscopy]: a surgical procedure where you can literally suck the shit out of people.

Medicine is not just about saving lives. We all know this from as early as our medical school days. It's about that human touch. Reaching out. Asking if they are alright. Yes, it is always glorified on TV-- we all know that taking a patient to theater doesn't just happen at the snap of a finger; you have to ring the theater nurse-in-charge and argue firmly explain why they should open up Theater 3 for you when there's a possible Caesarean section happening or an emergency lapatoromy being prepped as you speak. You then have to ring the anesthetist up and have a bloody good reason for him to come in at 10 o'clock at night to put your patient to sleep. You also have to notify the nurse-in-charge of the ward or the bed manager so that they can find your patient a bed when you're prepared to wheel him out of the operating room. If you think your patient needs ICU support, you must also convince the ICU people why they should turf one of their sickies off to a normal ward to make space for your post-op patient. And of course, no doctors-- emergency or trauma teams-- would actually have the time to wait outside for an ambulance to pull up so that they can be the first ones to wave a pentorch over their eyes and dramatically declare that they're "coning" and that we need to "move them to theater, NOW!!!". Television is so misleading.

Long, languorous Sunday afternoons aren't supposed to be spent doing exam questions. They are meant for picnics in the park, or curling up on the sofa with a good book and a mug of green tea. They are meant to be fallen asleep upon, gently easing into their soft, quiet folds so that when you wake up a few hours later, Sunday afternoons will still be filled with that muted glow of the setting sun, delicately plucking you out of your mid-afternoon slumber. That's right. Long, languorous Sunday afternoons aren't supposed to be spent doing exam questions.

Me: So, what was the reason for this kid's circumcision again?
Surgeon: Parents.

After turning 25, we'd all know someone in our generation who's pregnant or who's already a member of The Parenthood. It's even more ineluctable with the omnipresence of social media in our lives: the 12-week ultrasound scan of one's fetus on Facebook, the X-Pro-ed photo of a smiling kid on Instagram, the picture of a newborn circulating on Whatsapp group chats... Suddenly, everyone's attending baby showers, gushing over the new lightweight aluminum stroller like it was the recently-launched BMW i8, and throwing #oneyearold #birthdaybashes for their kid who's probably not going to remember this event as much as their social-media-savvy parents. Well, here's the thing: I was watching Sex and the City re-runs on Saturday night TV, and Season 1, Episode 10, titled "The Baby Shower", resonated with me when it comes to Carrie and Miranda's opinions on babies and "The Motherhood", as Miranda aptly names it-- the cult in which "they all think the same, dress the same, and sacrifice themselves to the same cause-- babies". It's not that I'm terrified about being a mother, but the knowledge of antenatal issues (reflux in pregnancy, hyperemesis, anaemia in pregnancy-- hello, I'm already frigging exhausted as it is-- weight gain, pelvic pain, back pain, gestational diabetes, pre-eclampsia... do I need to go on?), as well as being privy to what happens during labour and delivery, is enough to put me off. I like kids (most of the time anyway), but I'm afraid I like dogs more. My dog is my baby, and lately, he's been sleeping with us, in our bed. His favourite spot is that narrow space between my husband and I. And this morning, in that dreamy state of being half-asleep and half-awake, I realised that my dog had scooted up next to me and was resting his head on my chest, his heading bobbing up and down along with the rhythmic rise and fall of my chest. As I snuggled closer to my husband, who had turned over to give me a cuddle, I drifted off to sleep again, my hand on my dog's back, with my husband's arm draped across mine, and it felt as complete as a family could be.

Thursday, October 23, 2014

Letter 712: Private Conversations in Public Places

There is a Gentle Giant in town that every one fears, loves and respects at the same time. His 7-foot frame towers over most dwarfy townsfolk, and his booming voice commands instant attention. Yet for all his gargantuan physique and seemingly contumelious demeanor, he is actually a softie who makes clown faces at toddlers and is an invaluable teacher in the observations of human life:

Lesson 1
On the passing of meconium and the subsequent splatter of fecal material all over the sheets during a routine vaginal delivery, and my aghast reaction to it:

"Don't worry Junnie. It's just Vegemite."

(Yeah, except Vegemite tastes better -__-)

Lesson 2
On the benefits of having 2 cars:

"So, Junnie, I had a flat tyre as I was coming outta my driveway."
"So I heard. Did you change the tyres?"
"Nah, I just changed my car."

Lesson 3
On the Psychosomatic Back Pains that come in full of angst, wanting repeat scripts for narcotic analgesics and/or specialist referrals:

"So, about that lady with the back pain..."
"She's mad."

"Oh, you know the guy who wanted a referral to see the neurosurgeons...?"
"He's mad, too."

Lesson 4
On the failure to retrieve a baby via Ventouse suction from a primigravid woman's birth canal:

"Aaaahhh... FUCK!!!"

Lesson 5
On me being too hard on myself for missing a potentially fatal diagnosis:

"Jun, we all make mistakes. Look, I make mistakes too, but with my experience, I may make less mistakes, but nevertheless, I still make mistakes. We make mistakes because we're tired, we've had a long day, it was an unusual presentation, or, like you, we haven't got much experience. In time, you'll learn that no doctor is perfect, much as we all like to be."

Lesson 6
On me inducing a vasovagal reaction after attempting to insert a cannula into a guy:

"Young lady, do you always make men pass out in your presence?"

Lesson 7
On the mushrooming of speed cameras in town lately:

"Jun, beware of speedos."
"Well, do you want another speeding ticket in the mail?"
"Oh... you mean speedos as in speed cameras, not the swimming trunks!" *facepalm*

David Duchovny in Speedos that are now worthy of its place in the Smithsonian. #hotdamn

Lesson 8
On the dangers of being a surgeon:

"Surgeons don't know how to treat diabetes; they don't know how to treat asthma-- all they know is how to cut up a lesion or a body part, and leave the bloody mess to the physicians!"
"And your point being...?"
"Jun, Jun, Jun... I'm afraid you're starting to become one! Ain't that scary!?"

Lesson 9
On handling stoic, obstinate German stock:

"He's German, and you don't tell Germans what to do. They tell you what to do... So he wants to see Dr. L instead of Dr. W? Fine. Refer him to Dr. L then."

Lesson 10
On managing the pediatric patient:

"Most of the time, you don't really treat the kid. The key is to treat the parent."

Lesson 11
On managing hyperchondriac/ overanxious patients or those with significant fixation of symptoms:

"... In addition to her UTI, she's also got significant fecal impaction, which I think is most likely the cause of her constipation as there's no history to suggest other causes. Are you happy to give her Microlax (enema)?"
"Nah, just give her some Augmentin Duo Forte-- she'll probably get diarrhea and that'll settle her constipation as well as her UTI."

NB 1: I wrote this piece in my intern year, under the tutelage of a mentor who would later have a profound influence on my career choice.

NB 2: I've had this post in my Drafts for almost 5 years and have refrained from publishing it till now, not because I had anything else to add (what you're reading is exactly the same from 5 years prior when this post first materialised), but because there were 11 Lessons and the Obsessive-Compulsive Perfectionist in me didn't like how there was 11 Lessons and not 10, 15, or 20. 

NB 3: So why am I publishing it now? I realised my last few posts sounded quite sombre, so I wanted to make you laugh. 

NB 4: Are you laughing? Why not? At least I know how to manage diabetes now. And asthma. Pfft.

NB 5: And also because I kinda miss this specialty and all the lessons it has to teach. Especially Lesson 5.