It's the dreadful dinner time approaching again, and I'm faced with this problem for 90% of the time here ------- WHAT TO EAT FOR DINNER?!?!?!?!?

I love my food..serious! And I don't think anyone will believe in me saying this after seeing how petite I am...sigh.

But it really is a pain-in-the-ass having to crack my head abt what to eat for every meal everyday. Good thing is...I don't have to think abt bfast, but only having to start thinking abt it now that I've start placement again..and if I don't eat a bit, my tummy will growl...and u noe what? Now even if I have a croissant or 2 in the morning with a hot cup of milo, my tummy starts growling at about 9am!!!! And then I'll just have to be cheeky by having a biscuit or 2 from the surgery, plus cups of tea with lots of milk added to it.

Lunch is a pain cos there's no restaurant or fish bar ard..and I have to resort to eating sandwiches which I so dread. I'm not a fussy eater..but it's understandable why I get phobias of bread right? How will you feel after 5 mths of eating char kway teow everyday? Even if it's bloody delicious, u will still develop a phobia right?!

Then comes dinner. THE MAJOR PAIN OF THE DAY!!!!!!

There I am feeling so exhausted, dragging my feet to my flat, only to realise that I still gotto cook dinner. I actually counted the number of houses I am out of the house on weekdays, and it is actually about 12 hrs everyday. After all the cooking and washing, I'm only left with 3 hrs at most to study and then head to bed.

My life sucks here already, and I don't need dinner to drag me down further.

I'm having a lot of food cravings, and I know I'm being shit for wanting dinner outside everyday, but I can save a lot of time (ok, maybe not much), but at least I save the trouble of washing dishes plus I have enough nutrition to keep my frail body moving.

I'm dying to have a plate of fried bee hoon from the Singaporean restaurant here at the moment. Actually, I wouldn't mind another round of steamboat too. But I'm sure my bf won't go with me, since he said he wanted Chicken Rice, and that actually turned me off because I don't want to be cooking dinner for us again tonight (I was so tired that I slept 11 hours) until he said he'll do it himself.

I'm so frustrated at the moment. I just wish I can come home to having dinner laid on the table for me after having such a long day, but I know it's close to impossible. I'll be glad enough if I didn't have to cook dinner instead.

If only I'm in Sg, life would be so much easier. Till then, it'll be more of a choice problem, not knowing if char kway teow or mee pok is better. But at least, I'm guaranteed that I have dinner to eat without having to cook!

I'm hungry...*sob*

Maybe I saved her life? *glee*

I'm feeling happy today because I spotted something which the doc missed, and I had to go running after the patient to get her to go back to the Consultation Room because we needed to question her further.

It was a female patient complaining of left iliac fossa pain (the area directly opposite that u get for appendicitis on the right). She had her right ovary removed 3 months ago because of a large cyst, and everything was ok post surgically. But for the last 2 days, she got an excruciating pain on the left side and it felt like the pain she had on the right last time. It was extremely debilitating, and she managed to seek help only today after it went away with some strong painkillers. In the history, she also mentioned that she hasn't had a period for 2 months, and from looking at her, I knew she wasn't menopausal yet.

She wasn't given a diagnosis, but blood forms, referral to gynae, urine sample which she can bring in whenever she likes etc. Apparently, the system here in UK is different from sg whereby u can get basic tests like bloods and urine all done at the GP's. Here, u have to go to the hospital, and u can choose when u wanna do it..just bring the form will do.

A middle aged lady with abdo pain....I remember being told umpteen times that I should always query pregnancy in any female coming in with lower abdo pain who hasn't gone through menopause and it sticks in my head since I used to forget about it quite often before, and was told how dangerous it is if I miss an ectopic pregnancy.

No periods for 2 mths sounds dodgy, so when she left, I asked the doc "Do you think she could be pregnant? 2 mths without period...". The doc got speechless for a moment. "She could well be. Oh dear, can u please get her back in here? She'll need to go to the hospital immediately then."

When she came back to the room..

Doc: I got you back because of an important point made to me by this medical student, which I definitely have to ask you about. Do u think there's a possibility that u could be pregnant?
Patient: Yes..there could be a possibility even though I did have sterilisation because I haven't had a period for 2 months after sterilisation..
Doc: Hmm..well..I think we shall not delay the referral. It's best if u head to the hospital now and get all your urine tests, and bloods done.

Seems unlikely that she might be pregnant since she was sterilised, but sterilisation isn't 100% too. I heard from docs before that there are some women who have Filshie clips put in, and end up having ectopic pregnancies....even though it's rare.

I'm not sure what her pregnancy test results will be, but if she was indeed having an ectopic preg, then I would have saved her life. :) Of course...I hope it's nothing lah...but it's always better to be safe than sorry..

Don't bloody understand some people!

Here I am, stuck in the IT room whilst waiting for my weekly teaching (cum argument session..*rolls eyes*), when I actually planned to do some studying in the library.

I was good, cos I stepped into the library, and till now, I wonder why my coursemate said the library is nice. I didn't find it nice at all. My thought of a nice library is one with modern facilities, with modern tables, comfortable chairs, totally high tech, not one like in this hospital. Apparently, the library is situated in an old chapel, so you can well imagine it to be wood totally, with wooden stairs and stained glass, and shelves filled with old books. Some people might like it, but not me...I think it feels ghostly, explaining why I'm here blogging instead. Sigh...

Had a very interesting Geriatrics Case Discussion yesterday at the hospital, and I saw a few patients with excellent signs, especially the guy who got Parkinson's Disease...manz..was he classic!

Then I kinda got irritated at some point during the session cos of X. I can't stand this person honestly. I don't understand why he gets so argumentative about every single thing, and can't stay humble. We were interpreting some chest xrays in the wards, and Y didn't know it too well. X was then telling him what he thinks, in the tone like as if he's the Consultant. Mind you, the REAL Consultant was next to us, watching us interpreting, and he told X that what he said is all wrong!

Manz, it must felt like a slap to his face. Honestly, if I were to be a Consultant one day, I would dislike such students. I mean, fair enuff if u know lots, but stay humble. Hate people who are not experts but talk like they know it. In fact, when I was in a bus with some juniors once, I could hear them talking about some patient they spent a long time taking a history from and examined in the wards, and were having a guess at her diagnosis...and one of them was like "I'm sure she's got a perforation! I'm dead sure abt it!!! Trust me, it's a perf!" Then the other students were like so amazed at their act-smart coursemate about his fabulous and so ever exciting diagnosis made, since they were all confused.

I said nothing, but being 2 years their senior, and definitely knowing more than them (even though I'm still shit..), I knew it wasn't a perforation even though I didn't see the patient. Firstly, if that patient got a perf, it would be an emergency, and she would be dying and needing immediate surgery. Why on earth would she still be lying in the wards, with the mood and energy to spend a long time letting u take a history from her, and worse, let you examine her? She would be in tremendous pain. I couldn't have imagined them doing an abdominal examination on her while she's having a perforation....sheesh...

Honestly speaking, my first thought of that Mr Genius who came up with Perforation as a diagnosis is that he's a complete idiot. But I just pretended not to hear anything. Perf he said, Perf it shall be then.

I can understand the enthusiasm and excitement about trying to work out the diagnosis, interpreting results etc, but I mean...thinking you are dead smart is such a major put off. And mind you, I've seen a lot of people in med sch who are like that.

Also, you also get some who are fighting with the Consultant to teach their own coursemates. Imagine your coursemate and the Consultant speaking to you at the same time...pisses u big time since u don't wanna show no respect to both of them, hence, trying to keep eye contact at intervals with BOTH of them, and at the same time, struggling because u're getting more and more irritated with your coursemate for talking unneccesarily, or sometimes, acting as the Consultant's parrot.

I think we're all in the process of learning, even if you're a Consultant, and we should all stay humble no matter what rank you are.

If I'm the Consultant and I get such students in future, u bet I'll not give shit abt them. They don't deserve to be taught at all since they're already so "smart" no?

Charlotte Church - Just Wave Hello

My old time favourite. Just thought I might share it :) Yup, I've always been an opera fan, just in case u didn't know.

My favourite day of the week..Friday!

Love it so so much when I get half days off (my tutor's really kind) on Fridays. I haven't been updating partly because there isn't much to update (I think..) and partly because I have been so exhausted that I am totally out of touch with the world. No kidding on this one. The only person I am in contact with here is my bf and even MSN...I rarely have it on, plus...I am always away doing something else when my friends msg me...and hence, me not replying.

I shouldn't be complaining abt my placement since I'm given somewhere not too far away from Cardiff, and I have been given such a wonderful tutor. But it's quite tiring since the hrs are long, and I'm usually out of the house before sunrise, and back after sunset.

My boy's been lovely and supportive. Hugs from him just gives me so much consolation everyday. And I appreciate his effort to let me sleep and have the whole bed to myself while he does his work throughout the night, and then sleeping after I've left the house. Sigh, my "sleeping time" seems like the only time we are physically together now.

Weather in UK is getting tremendously depressing. Gosh, it's been raining raining raining. Gale-force winds joined in as well, and it got so bad that my flat was shaking. There has been a few times whereby I got woken by it, and had to go close the windows just in case the windows get blown off.

Weekly teachings have been interesting, but somehow frustrating in a way since there are people in my group who have got so much opinions abt every single thing that they have to fight it out with each other during discussion. It got really out of hand last week when they were literally raising their voice at each other over ethical issues of whether antibiotics should be prescribed to patients with a cold, and the doctors tried to interrupt but they were totally ignored and the battle continued.

Obviously, we, as medics, know that most colds are viral and hence antibiotics are not going to help things unless the cold has been persistent for weeks. But patients who don't know much abt these things, will think antibiotics will do them good, and hence ask for them, leading to the ethical question of whether we should or should not give it to them.

Arguments started when "What if the GP surgery is privately owned and that the GP has to be responsible for keeping his business going?" made the issue complicating. One side was arguing that the doctor is unethical for prescribing antibiotics to the patient when he knows it's useless, and hence with such unethical docs, it's no wonder why antibiotic resistance exists. Then you have the other side arguing that if the doc doesn't prescribe drugs to earn money, and also losing the patient to patronise the surgery in future, he's going to go bankrupt before he knows it, and what's the point of being so damn ethical when u are an unemployed doc.

I felt really unfortunate to be sitting between this 2 argumentative guys....grrrr. It's actually really simple, I thought. There's no right and wrong to this situation and since it's privately owned, it's the decision of the doctor who owns it no?

If he thinks he rather be completely ethical to the extent whereby it doesn't matter if he goes bankrupt again and again (pity social services..), then of course, he has all rights to insist on practising evidence-based medicine and say "NO" to give antibiotics for a cold and risk losing his patient who thinks he's whatever-they-wanna-say, without the patient knowing that the doc cares for his patients so much that he rather go bankrupt. *rolls eyes*

Then you can also choose to be a completely unethical doc who argues that antibiotics isn't going to harm the patient plus it brings in the bucks and if it so happens to be bacterial (since u can never tell if a cold is viral or bacterial), u hit the nail on the spot. Yet if it's viral, it's going to get better in a few days even if the patient doesn't take the drug, but since the patient will take it, he might think the doc is good for ending his misery. And as a result, he gets to keep his patient, when the doc is actually a bastard thinking abt his money and not anything else.

OR you can also choose to be half ethical and half unethical by giving antibiotics, but telling the patient that you doubt it will help, but take it nevertheless just in case it isn't viral. You earn the bucks, and at the same time, u can stop yourself from being pointed at for being unethical since u did inform the patient and it's their choice of whether they wanna take it or not. Chances are u get to keep your patient while being partially ethical, provided your patient doesn't turn round and say u're always giving him drugs when u know they are useless but just wanna earn the bucks.

If I were the GP, I would go for the "half ethical and half unethical" choice.

Then yesterday, it was a discussion about whether parents should smack their children. There has been a lot of debate about the limit of physical abuse. One can argue that if the parent smack the child a lot for right reasons (again...what is considered "right" and what is considered "wrong"?), it is not physical abuse, while another might argue that it's wrong to hit the child and how hitting him/her will cause emotional scarring and what have you about affecting them to grow up healthily etc etc (feel free to exaggerate the whole situation since i'm sure there will be ppl agreeing).

I think it is very subjective. You can't bang on the fact that if u wack the child, the child will grow up being scarred emotionally and hence, can't grow up into a healthy adult. Yet, you also bang on the fact that if u don't wack the child, u're providing a healthy environment for the child to grow up in, hence it's for sure that the kid will be good.

A few of my classmates in the group have been wacked a lot by parents. I, too, am one. One of them felt that most of her smackings were unjustified for, and till today, she couldn't understand why she was wacked so much. But I felt differently from her. I knew that I was wacked for a particular reason, regardless of whether it was that major a mistake that I deserved a wack rather than just a lecture. I think it did me good, despite me hating being wacked. And till today, I'm grateful for the wackings my parents gave me, because I wouldn't be in medical school if it weren't for them, and I know that it pains them just as much as how it pains me when I get wacked. Trust me, I know how hurt they are, because I heard my Dad weeping once in the toilet after he wacked me.

Yet, some children might hate their parents for hitting them because they do not think positively like me, and hence, rebel against them. Then social problems start, and parents get blamed for causing the emotional scarring of these children.

But before we point fingers at parents, maybe we should think about cases whereby parents do not wack their child. "Spare the rod, spoil the child" is the common phrase we hear often. Some kids just don't learn when parents talk to them about their fault, and continue with their intolerable ways, and give social problems when they grow up. And there are some who just grow up to be proper.

I believe that whether a person gets led astray or not depends on numerous factors. I strongly agree that parents and the child's surrounding environment has a huge influence, but the child's maturity also plays a major role. If you get a child who grows up in the best environment (deemed by society as being the best, of course), but he's just immature in deciding what is right and wrong for himself, and not thinking abt the consequences, then it's too bad for him. There are numerous cases of children who grow up in poverty, being smuggled abroad at a young tender age to fight for survival alone without parental love and a proper home, but end up being successful people and understanding the emotional turmoil their parents went through. My bf already knew a few like that.

Sigh, there are still other issues we were discussing about, but I'll probably spend the entire day typing out, so I shall just stop here.

I really think people in my course should start a "Medical Students' Debating Society", so that we can all spend a few hours a week debating amongst ourselves and trigger thoughts and reflections over ethical issues. Hmm..I can see why some people I know are so against to dating medics now.

We are, definitely, a bunch of very opinionated people who go all way out to argue and put our point across. Haha...

For the 2nd time, I fell ill in the plane!!!! Bah! I thought the first time was horrible enough, and hoped I'll nv encounter it ever ever again, but....I still experienced it one more time!

The first time was horrid. I was so ill that I dozed off in my room without even removing my shoes...and my head was spinning like nobody's biz.

Yesterday, before I boarded the plane, I felt that my duodenities was acting up again. It's been torturing me at various intervals for the past few days, so much that I was wrenching a lot at home and in public (what will people think?!), and losing my appetite.

I started feeling feverish, and popped a few pills, praying hard that it'll go away. The gnawing feeling was there even when I went up the plane, and the moment I settled down, I was extremely exhausted. I felt very unwell, and wasn't very much aware of anything that was going on around, except the cabin crew serving me a hot towel.

The flight was a torment to me since I wasn't able to get into the most comfy position to doze off in, despite given the best seat in the economy class (the one with the big leg space). My joints were aching, and no matter how I twisted and turned, tossed and flopped, I was still uncomfy.

I was wishing so much that my bf was at Heathrow to meet me and help me with my luggage when I arrived because I was so weak that pushing the trolley was a chore.

But thank goodness he was there at the coach station in Cardiff, as promised. He said I looked very ill (now I know why so many people were looking at me at the station).

Popped more pills when I got back to our flat and laid on his bed, happily tucked under his duvet. It was difficult to doze off since I was "boiling". But I still dozed off eventually after a hot bowl of miso soup (yummy!), and sleep talking a lot (I was dreaming about some building infrastructure and when my bf woke me up, I recall briefly telling him how impt the foundation is and that it must be very strong and stable before we can make a good building...*rolls eyes*).

Finally, woke up to find that it's 12 midnight. HAPPY NEW YEAR!!!!!! Ok, I was actually awoken by the sounds of the fireworks outside my flat. My boy was already snoozing next to me. We missed the countdown...SHUCKS! I just hate myself for falling ill when he said he didn't want to wake me up earlier since it wasn't easy for me to doze off, and that I needed a lot of rest.

Feeling much better now, but my appetite's still bad. Couldn't even finish my bowl of instant noodles... Hopefully, I'll get better after a good night's rest tonight.