Letter 417: Humour is a Workplace Requisite

At the Wacky Shack, it's not Doctor Jun, mind you. It's Princess.

~*~

It all started with me wearing a headband to work. Jenny thought it looked so much like a tiara that she started calling me her "Little Princess" ("little" because I was petite compared to her towering figure)-- to which I reciprocated her love by addressing her as "Your Majesty" ;p And then of course word spreads quicker than the onset of action of olanzapine, and soon, Jenny's troop of nursing staff started using this term of endearment in the ward, and even dared me to wear a tiara (to which, in all innocence, I responded positively-- hence the materialisation of this unexpected bling in a seemingly innocuous white paperbag at my workstation).

As Her Majesty would say, it's all "behavioral" ;p

So yours truly ended up wearing this tiara the whole time while giving a powerpoint presentation to the nursing staff -___-

~*~

DAMN YOU PEOPLE WHERE IS THE RESPECT, Y'ALL!! R-E-S-P-E-C-T!!!

Technorati Tags: work, medicine, life, humor, funny, laughs

Letter 416: Reflections

Working in the psych ward, I've always maintained that if I weren't a doctor, I'd be a scriptwriter earning megabucks in Hollywood. The stories you hear! The characters you meet! The drama in the ward! I could just see myself writing out a film script based on my experiences here over the last 10 weeks :P

I could tell you many a funny encounter, like the eccentrically entertaining Blue Man who, sadly for me, was discharged yesterday, or encounters with characters so delusional that it's sometimes easier for us to play along with them in their own loopy world ("Oh, so you're a hobbit? Really? What do you eat?" *Feigns look of amusement*).

Then there are heartrending stories that end in circumstances you'd never imagine. One such story is a story about a patient whom I've had the pleasure of looking after since the start of my rotation in psychiatry. He's just been discharged today-- 10 days before the end of my rotation. Thus he's been practically under my care since, like, day 1. And truth of the matter is, we never anticipated there would be a day like this for him.

You see, his story is a complicated one. He had actually been in hospital for almost 8 months before he was finally discharged. He had been in 2 different hospitals prior to being transferred to where I was working. When he first came to us, we were quite perplexed by his presentation. Leafing through old notes, gathering collaterals, soughting input from different professors, and discussing the case with my consultant were what kept me occupied for the most part of my rotation, especially during the initial stages of his stay here. Playing sleuth was one thing; solving the mystery, another.

It is an uncontested truth that some things in medicine may remain a mystery forever. Over the last few months as an intern, I have come to grasp this truth more firmly than before. This patient of mine was certainly a diagnostic conundrum, and till now, I can honestly tell you that we never had a conclusive diagnosis for him. Nevertheless, he settled well on his medication regime (which had been modified numerous times ever since he got admitted last year), and responded relatively decently to a few zaps of electricity to the brain. Ooh, the wonders of electroconvulsive therapy!

Over time, he emerged as a pleasant chap whose promising young life was, tragically, complicated by his parents' divorce and his mother's subsequent move to the Pearl of the Orient, as well as the emergence of his mental illness. He was only a year younger than I. Interestingly, he took up Chinese lessons in uni, and, one day, when I gathered he was less muddled by the effects of the ECT, I took the liberty of testing his Chinese, and found out that he could still converse adequately in a smidgen of tainted Mandarin. He even showed me an exercise book filled with Chinese characters he'd learnt. How those rigid strokes reminded me of the way we used to write when we were in primary school! And certainly, the way he behaved sometimes reminded us so much about a primary school kid, if not someone younger. Nonetheless we believed that this was his usual self, and though he may have seemed somewhat immature, he was overall a sweet lad whose ultimate goal is to fly to Hong Kong to look for his mother (can you picture a scene unfolding in Tsim Sha Tsui whereby a young backpacking gwai loh searches his tattered address book for his mother's whereabouts on Nathan Road, and asking the ah paks for directions to her place? Yep. Cinematic.)

In psychiatry, as most patients tend to require longer hospital stay, one tends to grow fond of some patients from a distance-- or rather, fond of the little delights that they bring to the ward unknowingly. Each patient has their unique quirkiness, such as the guy with "caffeineism" who puts EIGHT HEAPED TABLESPOONS of instant coffee and concocts a concentrated elixir of caffeine with minimal amount of water, and who carries his concoction wherever he goes but walks with such exaggerated arm swings that he leaves trails of coffee drops behind him! When he leaves, I suspect we would miss the fun of locating his whereabouts by tracing his coffee trail :>

So it was with this long-term patient of mine that I felt a bit disappointed to see him go too, just like how I was crushed when the Blue Man was discharged (oh he was a classic indeed! And perhaps one day, I shall unfold the Story of the Blue Man-- co-starring Skippy the Kangaroo). Though having said that, I could never have been happier to see him leave. It's a rewarding experience, as a doctor, to see your patients improve, and even though the course of mental illness is difficult to gauge at times (ie never knowing if they've actually been thoroughly "cured"-- hence using the term "improve" in place of "cure"), I firmly believe that if we spent enough time with patients, have a little optimism, and put a little faith in them, they may be on the speedway to recovery. Then again, I'm always a little optimistic when it comes to my patients haha.

Oh and guess what? Before he left the ward, he actually came up to me and shyly asked me out on a date! I was flattered and pleasantly disturbed, to say the least, but of course I said no lah and told him to focus on getting himself better, though his reasoning of "I wanna ask you out because I think you're beautiful on the outside, and also beautiful on the inside" will forever serve as a reminder that being a doctor is an honor, a passion, a calling, and not merely a job.

On a side note, this is why doctors should also treat nurses as human beings and not merely someone to yell at. Thank you Lisa for your homemade galaktoboureko! Dang I still owe you a drink at the pub!

Technorati Tags: medicine, internship, intern, doctor, doctoring, hospital, psychiatry, mental health, musings, work, career

Letter 415: The Perfect Summer

The Summer of 69 may have been Bryan Adams' best days of his life, but for me, I'll always reflect on the summer of 2008 with a wisp of longing, for even though those warm, balmy summer days had seemed like a lifetime ago, the summer that began exactly today, 365 days earlier, was, for me, the best summer days of my student life:

Happyness on arrival :)


That which got me through 8am rounds (no, it wasn't Oxford!)

Hasty breakfast balls in tau foo fah and soy milk at Mr. Bean's, located in practically every MRT station and at certain hospitals.

Jagung ice-kacang was a $2 treat at the hospital cafeteria when I wasn't scrubbed up in theater.

Daily fluid intake *slurp*


Jap is a must. Always.

My little carton of Hong Kong during those solitary Awfully Chocolate afternoons.

Humble $2.50 chap fan after one-too-many Jap dinners.


Summer thirst-quenchers. Milo Dinosaur, oh, Milo Dinosaur!


$ummer $ales :D


Summer longing.


Summer belonging :)

How will this coming summer fare? I shall tell you in 2 weeks' time *wink*

Technorati Tags: summer, life, photolog, photography, photo essay, singapore, personal

Letter 414: "Situational Crisis"

I have always looked at Neurosurgery and Rural GP as two sides of a coin. Like Two-Face/Harvey Dent and his compulsive ritual of flicking his own coin to determine his victims' fates, I, too, have at times, mentally tossed this coin during certain crossroads, and praying hard it'll land heads up ;)

Lately, I find myself at such junctures again. It's that time of the year when applications for MO positions are open across the nation, spurring a sudden rush of madness and agitation in the veins of young doctors like yours truly as we scout around for referees, tidy up our CVs, rehash our Cover Letters, and prepare ourselves for interviews.

Amongst this mad flurry of events, I toss my coin again in peaceful resignation, and while I await the destiny it foretells, something else catches my eye:



It's the recent news about a life-saving emergency burr hole surgery performed by a country GP with just an ordinary household drill. Remember an episode in Grey's where Izzie-- or was it George?-- had to perform a similar procedure? It was certainly a case of art imitating life imitating art.

And so I thought perhaps this was my prognosis, but my coin had in fact landed on its rim and was pivoting to a slow stop: Something else landed in my lap today-- the diagnosis of a meningioma in one of my patients who had initially presented with severe depression, which most of us were ready to dismiss as yet another case of "situational crisis". Like all fates determined by the toss of a coin, there's always a 50/50 chance. In her case, removing the tumor may not "cure" her depression entirely, as she also has a long-standing history of unresolved PTSD stemming from childhood sexual and emotional abuse by her father (oh the vivid recollections when I interviewed her! *Shudder*). However, there would be at least some therapeutic benefit when her tumor is removed.

And thus my coin continues to spin on its axis, buzzing like a high-powered drill :D

Technorati Tags: medicine, life, internship, interns, career, musings, personal, neurosurgery, rob carson, nicholas rossi, burr hole surgery, subdural hemorrhage, rural doctors, rural general practitioners, news, australia

Letter 413: Hello, and Goodbye

To me, those unexpected doorstop moments bearing roast chicken spiral pasta and Sara Lee ice-cream with a bashful smile of hope will always be our Juliet and Mark moments. Except ours was punctuated with banter instead of silence, and tummywarmers instead of place cards. And while you walk away in spirits, I am left standing at the doorway, resisting the urge to do a Juliet.

Technorati Tags: life, shorts, stories, people, musings, love actually, personal

Letter 412: In a Heartbeat

Every Saturday evening, she jogs her way to the oval and sits on a bench beneath the old pine tree. Of the 20-odd wooden benches that frame the oval, she likes this bench in particular. Its location under the colossal pine allows her lanky torso to be strategically covered in the shadows, and affords her the freedom to stelthily observe the local boys indulging in their evening pursuit of tackling an olive-shaped ball on the playing field.

Although she has never understood the nation's favourite past time, she enjoys watching the thrill of the chase. The sustained running punctuated by roars of victory is enough to turn the corners of her mouth upwards. She smiles from the reverberation of the enthralling vibes that are generated from the heart of the oval time and again, like those from the epicenter of a quake-- except these are good vibrations, spurred by the victorious response evoked on the playing field.

She usually sits and watches the game for a good 15 minutes, occasionally taking a swig from her water bottle that she carries during her evening jogs. The boys don't know that they have a silent spectator in the shadows. They have their dads and coaches to cheer them on in the open. Ah, such warm, young blood on the fields. Golden hair and tanned athletic lads with big blue eyes and lopsided smiles that would surely score them endless amount of dates. But there is a particular boy that has caught her eye. He stands out from his mates because he has an unruly mop of chestnut mane and a few freckles on his cheeks that still harbour some baby fat. He is slightly taller than his mates, though just as equally as muscular. She has been observing him for a few Saturdays now, and thought he was the best player on the field.


Today, as usual, she sits on her favourite bench, watching him from the shadows. He had almost scored another point if not for a slight misjudgement that had sent the ball flying towards her direction. Her heart lurches, unprepared for this moment. It's a decision between staying hidden and risk getting hit by a high-velocity footy ball, or emerging from the shadows and risk exposing herself. She decides to avoid any incidental sporting injury, so reluctantly she jumps up from her bench and takes a few steps sidewards. Her eye candy is already making his way towards the spiraling ball; towards her.

"Sorry!" he grins, imposing his boyish charms upon her as he bends over and scoops up the ball that had landed a few feet from her.

"S'ok mate!" She returns the smile. Taken by surprise, she had to keep reminding herself that he was probably no more than 16.

Technorati Tags: life, observations, people, stories, footy, sports, games

Letter 411.6: The 411 on Life-- Cut Diem

You stood in front of the mirror today, staring at your reflection for what seemed like eternity. In your hands were a pair of scissors: sharp, shiny, flicking off sinister glints under the harsh fluorescent light whenever you twirled the steely instrument in your hand circumspectly, debating on whether to cut, or not to cut.

In truth, you were actually waiting for courage to seize you.

But it never did arrive.

Technorati Tags: life, musings, metaphors, lessions, hair

Letter 411.5: The 411 on Life-- One Missed Call

You can pump up the volume of the idiot box in the hall, temporarily drowning out the droning buzz of your cellphone which you had deliberately buried under the thick folds of your quilt, all the while staring lifelessly at the 10 o'clock news, pretending to concentrate but not actually focusing on what's happening in the world.

Because you know that when the news is over, when you drag your frazzled torso back to your room, you reenter your world where, eventually, there is still one missed call waiting to be returned.

(Photo credits: Yashh)

Technorati Tags: life, musings, metaphors, lessons, shorts

Letter 411.4: The 411 on Life-- Concealers

Concealers can be such paradoxical adjuncts to beauty. Sometimes, they highlight your imperfections more so than do they conceal. In what you would then assume to be the perfectly natural solution, you dab on more concealer, only to discover the more you apply, the more discernible the blemish.

Then you realise the irony behind your futile attempts at covering up, for the damage is already done.

Technorati Tags: life, musings, lessions, metaphors, shorts, beauty

Letter 411.3: The 411 on Life-- Peanut Butter Crackers

You know they're not exactly the healthiest dietary choices. Yet there's something alluring about dipping saltine crackers into that tub of crunchy peanut butter, scooping a dollop of that sinfully rich stuff, and plopping it into your mouth for a sticky sweet crunch crunch sensation.

You deceive yourself by employing wholegrain crackers and stocking up on fat free peanut butter (hah!). Yet no one better than you knows that too much of a good thing can't be all that great.

But they're addictive, especially the pure, simple act of reaching out to them at night, under the watchful eyes of no one in particular. The thrill of knowing that you are the only sinner under the roof, the allowance for being naughty-- it's why you keep wanting for more.

Technorati Tags: life, musings, metaphors, lessons

Letter 411.2: The 411 on Life-- Crunch

As a student, you always dreamed that one day, instead of $20 Valleygirl dresses and $19 (post-discount) Miss Shop heels, you'd be swathed in $200 Pilgrim frocks and strutting around in $190 (post-miracle) Louboutin slingbacks.


Now that you're no longer a student, oddly enough, you're still clad in frugality: $9.90 Tempt cardi, $18 Nichii LBD, and $60 Guess stilettos (the occasional splurge).


Insofar as it can be ascertained, you can always change your style, but you can't disguise who you are beneath all that fancy labels.

Technorati Tags: life, musings, lessons, metaphors, fashion

Letter 411.1: The 411 on Life-- Oxy

It's like applying Oxy to your acne. The skin peels after a while, layer by layer, until you look like you've got dermatitis. But it doesn't make the problem go away, because underneath the xerosis, there's still an inflamed pustule, waiting to burst.

Technorati Tags: life, musings, shorts, metaphors, lessons

Letter 410: You've Got Male!

She was my first friend in med school-- and the first amongst my close circle of girlfriends to get engaged, married, and have a baby. Fate was an empty chair next to me on which she planted her perky gluts after bashfully asking if the chair had been taken, flashing me an angelic smile which I couldn't resist but reciprocate. It was our first day, at our first introductory tute-- Beyond Death, I believe, was the topic of discussion. We were initiated into the concepts of death and dying even before we got started on the physiology of life.

That seemingly inconsequential tute where none of us remembered anything that was ever discussed came to be the embryo to an invincible friendship that has blossomed over the years. Lazy afternoons of tête-à-tête by the Torrens under the willows, followed by nights of inebriated dancing, have nurtured this fetus well in the womb of our own little world of chocolate truffles and home-made sushi. As a result, an alliance of impenetrable loyalty and unabated affection came to be born.


It's hard to imagine her as a mother because she's still got such a cherubic face. But then again, she has always kept our friendship enthralling with snippets of surprises-- news of love lost and found, joyous tidings of an engagement, the grandiose tolling of wedding bells, the unsuspected announcement of her pregnancy that almost made me choke on our cone of melting gelati, and, 2 days ago, an unexpected text telling me that she had a SROM (spontaneous rupture of membranes) and was in labour.


She did well, that sassy sweetheart, giving birth to a healthy 3.3kg baby boy after a tiresome but virtually painless 14-hour labour thanks to epidurals. Welcome to the world, Alexander Felix! I think you'd be as smart as your mom, and as skillful a chef as your dad :) [That's not his dad in the picture by the way.]

Technorati Tags: friends, people, baby, babies, friendship, girlfriends, birth, delivery, musings, life, celebrations, birthdays

Letter 409: Friday Nights on Rundle

There was a time when Friday nights on Rundle exuded a certain air of eclectic sophistication that mingled with street chic. It was a picture of highbrowed discussions over bowls of risottos and glasses of vino, held amid the jazzy tinkles of live funk permeating the thick cool air from open bars. This lively scene was framed by curious onlookers in hooded jumpers and dark skinnies at the periphery, and for a very long time, it was a picture that testified to Adelaide's nocturnal vigour.

Sadly, though, Friday nights on Rundle have become a sleaze fest. The street is littered with fragments of broken glass, and heavily made-up platinum blonds tower over bouncers in their vertiginous platform stilettos and hooker fishnet stockings, taking long drags from their cigarettes while chatting up young Joes sporting mohawk cuts in denim jackets, chained down by their heavy artificial bling that hangs loose from their neck all the way down to their Converse sneakers and mismatched socks.

Nowadays, I'm just glad that work keeps me occupied on Friday nights.

Technorati Tags: life, musings, adelaide, rundle street, streets, city life, nights, cities, observations

Letter 408: The Existential Validation of Sundays

It took me a long time and most of the world to learn what I know about love and fate and the choices we make, but the heart of it came to me in an instant, while I was chained to a wall and being tortured. I realized, somehow, through the screaming in my mind, that even in that shackled, bloody helplessness, I was still free: free to hate the men who were torturing me, or to forgive them. It doesn't sound like much, I know. But in the flinch and bite of the chain, when its all you have got, that freedom is a universe of possibility.

Gregory David Roberts: Shantaram-- Part 1, Chapter 1.

2 hours and 5 chapters later, I walked out of Borders clutching Freedom in my hands-- all 933 pages of it.

Technorati Tags: books, shantaram, authors, writers, borders, sundays, life, personal, quotes, excerpts, novels