From childhood to adulthood

I got a huge surprise seeing this old photo being posted up on Facebook when I logged in out of boredom (I rarely log in there ever!).

My primary school photo posted by my primary sch classmate!

Can u tell which is me? (Save the pic and enlarge it if u want)

Got the answer? I'm the tiny tanned one in the first row, first from the left. Damn it, I really have the size of a baby mouse compared to the others.

And now..this is ME. Big change?!

Saved my patient! :)

Today's a great day. I was kept busy from the start till the end - very rare in my current post unless I'm on call.

I felt really satisfied at the end of the day, but even more happy because I saved a patient of mine who is dying, alone.

This patient hasn't been well over the weekend, and when I was on my ward round with my seniors this morning, he looked terrible. From his look, u can tell that the end is nearing. Everyone in the ward knew that he might be going off very very soon, but weren't very panicky about it because the "golden ticket" (as we term it in the hospital...is a form that says "Do Not Resuscitate") was right on top of his notes.

Honestly, there is good and bad to this ticket. The good is we prevent a patient from going through all the defibrillation, CPR and whatever aggressive resuscitation methods we have, when before touching the patient, we know for sure that he/she will not make it after considering his/her general state and comorbidities. Also, in some ways, it saves the relatives agony and mental torture if they are urgently called to rush down to the hospital to have a last look at their loved one, having to witness the doctors and nurses doing various things (most of which are not nice) to the patient (sometimes, u might even find them raising their voice at each other during times of conflict. yup, unprofessional, but it happens!). The medical staff will not have to be on their toes, and running down the corridor to the room when the cardiac arrest alarm goes off too (everyone gets on with their life basically..)

The bad is that everyone tends to lax once the "golden ticket" is signed by the doctor. Even if the observations go way off, the nurses would just bleep u but show no signs of panic or insist on immediate attention.

Apparently, this "golden ticket" is so important that whenever a patient doesn't look well or too troublesome to handle when ill, the nurses will come after your neck to ask u to sign the ticket (which u can so kindly reject if u feel that the patient should be resuscitated, and be prepared to be "cursed" by the nursing staff abt it). But overall, I must say that the doctors I know don't just issue "golden tickets" without valid reasons, which is good. The only thing I don't feel too pleased about is the lax attitude some tend to give later when they know that the ticket is done. I think if possible (after considering if the management might change the situation), every patient has the right to be given attention when appropriate and needed and be given the best treatment possible.

Isn't that what doctors are there for? We're not gods, and we are no position to determine if a patient should live or die, but at least, I think we should not give the patient a death penalty on the spot.

I was bleeped during lunchtime to review this ill patient of mine. While rushing to the ward, thoughts of what possibilities there are for his observations to go haywire continuously streamed through my mind.

In the situation I was given, there wasn't time to take a thorough history. I had to rely on all the information I have from his medical notes, and my clinical examination to come up with a diagnosis and differentials.

I drafted all the investigations and management, did them, and then informed my Registrar about the situation. It was pleasing to know that my Registrar agreed with my plan, came up to the ward to have a quick look at the patient and told me to continue with all my proposed plans while he rushes off for clinic.

I was left to do everything from scratch alone, from taking bloods, to blood gases, to oxygen, to venflons to catheters to sending bloods off to the lab myself. The only thing which I need not do was to sit the patient up and administer the medication. Pathetic eh? But that's how it is if the "golden ticket" has been signed. U won't get anyone around u to give u assistance, and there were times before, I had to shout so that nurses will run over to see what's going on.

The number of things I had to do on this patient isn't drastically huge, but still, it took me hours to get everything done and compiling all the results.

The struggle wasn't all for nothing though. Observations were repeated after I've completed everything, and I let a sigh of relief immediately when the nurses told me that the observations are stabilised and my patient's feeling better.

My Registrar came up soon after, and was really pleased. "What magic did u do? U've saved your patient. Well done!" he said.

That made my day. The satisfaction I got from today's experience is just wonderful. Definitely a confidence boosting experience and one which tested my ability to keep cool-headed and calm.

His mood has improved quite a fair bit these 2 days. And so did mine. Nevertheless, he's still as busy as ever. We've not been talking as much as before, and I occupied myself with dramas, revision, and reading random things that interests me.

"Sorry for neglecting you and I'm sorry that I am using the time which is meant to be spent on you to study instead. I will spend time with you during the weekend." Dearie said.

Although they were only words, it did bring some consolation that I was, at least, thought of. Yes, the weekend is here, but I'm not expecting him to specially set aside time for me. Having been with him for years, I know what is expected from his weekends. Weekends with him isn't what anyone would expect from a dating couple. Sometimes, it's better to accept the way it is than to ask for more from him. I trust that he sincerely wants to set some time to spend on only me, but things that go around him in China just doesn't allow it. Understanding has a limit, and I don't deny that it hurts and it's disappointing at times, especially during times when I need him. But I'm slowly coming to terms with the fact that this won't change, whether it pleases me or not.

He made me laugh when he calls my dad "Ling Dao". Dad is constantly in touch with my boy, and it's nice to know that they do chat free online even if I'm not around. My parents care a lot for him too. Dad's been quite concerned about how Dearie's coping with his job, and as usual, didn't fail to give him some words of advice and encouragement when I told Dad that he's been pretty frustrated recently.

Dad seems pretty excited about my return soon. He was telling me about how Mum and him were talking about me, and recalling how I packed my bags and left for the UK 7 years ago. Indeed time flies, and I've already spent my later teenage years and early 20s abroad alone. Life abroad has been quite a misery for me, and I have lost count of the number of times I spend weeping alone silently in my room. Way toooooo much has happened during my time abroad, mostly painful to think about yet unforgettable. But at least, at the end, I have gotten what I want, and it is now time to return home* to start a new chapter in my life.


*Whenever I think about my upcoming return home, I cannot help but think abt a friend who went to the airport to see me off 7 years ago. Before I left, he told me that he'll wait for me to return home for good. He was my guardian angel, but so many things happened between us throughout my years abroad, that we have stopped talking and lost touch. Even so, because he is someone I hold close to my heart, sometimes I would wonder how he would feel if he knows that the day he has been waiting for 7 years ago (my permanent return home) is finally here. Would he be relieved and happy to know that his wait is finally over and be excited to see how much I've aged? Or would it bring him nothing more but hurt? Or perhaps, it might not mean anything to him now if he has already given up waiting even as a friend. This, I'll never know.

Today, Dearie was very stressed from work. In fact, I haven't seen him being as carefree and as happy as how he was before for quite some time. Things got slightly better though, but it still wasn't the same as before. But ever since he started work last week, his mood plunged again.

It has been quite a while since he last taken it out on me, but because he isn't in his best mood, we haven't been talking as much as before. Hogging on the phone is still our daily practice, but there's less to talk about, hence, quite a number of silent moments.

I didn't feel good when I knew he had a bad day at work, and didn't feel any better when he got frustrated over the fact that he's got to work overnight again tomorrow (and his company doesn't pay overtime). We spoke very very little to each other online because he seems busy all the time, and I didn't want to be a pain.

I was quite pleased when he told me why he's fed up with his job, and I do understand why he's so. Who wouldn't be if u were given some position, yet doing jobs which isn't what the position states? The things which he's doing is important in his field, but they are "specialties" which he doesn't take an interest in.

I am worried that he'll quit soon. Honestly, I would be supportive of it if he can find a job easily, but jobs are not easy to come by these days. Also, many jobs in the market confers a person a certain position, but the duties are usually not one would expect. I am worried that if he changes jobs and realise that other companies expect him to do similar jobs as this current one and keep quitting again and again, there's nothing gained except having time wasted and having the CV marred.

If we're from the same country, probably I wouldn't be so bothered abt it. We've made plans, and after all that has happened throughout our years together, I have set my mind to press on. Maybe it's because I am holding high hopes towards this rship, that's why I keep feeling insecure. I've placed a very heavy bet this time, and I don't know what impact it will have on me if it all fails at the end.

Perhaps I was being very selfish since I was being more concerned about how not to lose this gamble I've taken, by worrying about how long he's ever going to take to reunite with me in Sg if he keeps changing jobs and how we're going to make our dream come true, rather than giving him the type of support he needs.

Being a complete IT idiot, when he went on telling me about his problems with his field, I wasn't able to comprehend. I actually got very confused and lost, yet I didn't dare to tell him, fearing that he'll lose his temper. When I was just listening and being unable to give comments, he wasn't pleased abt me being quiet. If I were to say something, he says he feels more stressed after talking to me. No matter how I react, it doesn't please him.

Whenever I get into this situation with him, a miserable and helpless feeling gets me. Dearie said he just asks for me to understand, and I swear I am doing that, yet nothing pleases him. I have no idea if I had done anything wrong.

This seems like a gap between us which I don't know how to bridge. This gap makes me feel like a completely useless gf. It makes me ponder if I'm the one for him. I can't help think that maybe another person who is familar with his field is more suited to be his gf. All I want to do is just run away when I meet this gap since I'm at my wit's end about handling this problem.

I'm just never good enough, am I?

Proud of Dearie

Dearie's just started his new job recently, and most days, he's working overtime. On his first day at work, he was already asked to work overnight.

It has been very tiring for him to cope with his long work hours, night classes and revision. Despite all that, I appreciate his efforts to send me messages whenever he can during the day, and contact me everyday. It's always nice to know how his day has been, and pleasing to know that at the end of the day, I have been thought of. Even if he's doing something else, we'll still be leaving the webcam on, and it keeps me happy just seeing him.

It pains me to see how tired he is, and I wish so much to be next to him in China to make him a nice cup of green tea and give him a hug to make him feel better. Am planning to go to Beijing around September for about a month, since I'll be having a few months' break before starting my new job. Shall go over and be the little housewife during then - house cleaning, preparing his meals (and delivering it if he's working overtime), grocery shopping, laundry, preparing his clothes for work :)

Dearie is handling a project at the moment, and he was telling me how he had to tolerate the snobbish attitude of the staff of his client. A guilt came over me at that point, because I know Dearie could have been a government official with greater power than those people and be in a position to thumb these people down. But it's because of me that he refused the job, and decided to seek his own means of survival.

Although he only brings back a reasonable salary (for China's standards), my love for him has grown even more through this. He has become more attractive in my eyes because he has changed so much for me. When I first knew him, he was a guy who doesn't look at price tags when buying anything, spends without giving a 2nd thought, says nasty things to me at times without considering my feelings and shouts/scolds people who irritates him in any way (esp on the roads). But now, he looks at price tags when we go shopping, thinks before he spends, and doesn't shout at people he doesn't know who irritates him (even though u can still tell that he's irritated when he walks away or doesn't seem to want to talk much). He doesn't horn unless necessary on the roads too. He rarely says nasty things to me now, and if he does, he apologises soon too. He's also becoming more responsible towards our rship by making sure we're in touch in one way or another everyday (he gets quite upset if he doesn't hear from me for even one day now). And most importantly, he has learnt to become less dependent by sourcing for his own job himself, learning slowly to see how the commercialised world is like without relying on anyone, and working towards his so-called 5 year plan for us.

This, makes me proud having him (even though it sucks that I still have a long wait more to go).

Those major exams

I chanced upon news abt China's "Gao Kao" (similar to our GCE 'A' Levels) on Xin Hua. Reading news abt this annual major exam brought a smile to my face, as it reminded me of my days in secondary school and JC.

Long gone were the days whereby I would sit in school exam halls in my uniform, having what I've revised over the months repeat itself in my head while waiting for the exam papers to be distributed. Those were the days whereby I'll be revising intensively everyday till the wee hours, and doing the infamous ten-year series to make sure I have familiarised myself perfectly with the type of questions which may appear in the exam. And not going to bed until I feel confident and prepared enough.

It was a stressful period, but it left fond memories as well. 'A' Levels were more memorable than the 'O's because I had a hard time coping in JC, and it had gotten to a point whereby I just gave up completely. I wasn't even expecting to pass it, and was even mentally prepared to repeat it. Fortunately, I managed to get through. I wouldn't say that I was a lazy student in JC, but I hated being in that college due to the lack of support. I had difficulty in catching up with my classmates as well, because they were all from a pure triple science class in their secondary school, whereas I was from a Pure Biology and combined Physics and Chem class. It was tough because they had a much better knowledge than me for Physics and Chem.

My results in JC sucks to the core, and I still remember how I would search for my name from the bottom of the list when exam results were released, and how I would compare with my buddy in class about how many subjects we have failed. Failing became part of my JC life, and slowly, I got numbed to it. My tutors didn't seem to care very much too, and I lost interest. Deep down, I had wanted very much to do well, but there wasn't much support around.

Once, I asked Dearie about how his memories of "Gao Kao" was like, and haha...like me, he thinks it's the most unforgettable experience ever. He claims that it's the most stressful period of his life as a student in China, and it got so bad that he had to go wash his face and hair to destress and keep himself sane. Dearie's got a very high stress threshold, and I can kinda imagine how torturing it must have been for him during then that he had to do that....hahahaha. Oh well, at least for all that effort, he did well enough to get into a top University...lol.

Really do miss those days, but no way would I want to repeat 'A' Levels again. I seriously don't think I'll do any better even if I were to repeat it either.

My long awaited weekend is here. I've been looking forward to it, and it's time to catch up with sleep. This week has been hectic, because quite a few of my patients are very ill and rather unstable. There has also been a few whom who are nothing but trouble, and that irritates me a hell lot, because firstly, hospitals are not hotels, and secondly, it is a place for those who r ill and wants to be treated, not a playground to come to when u feel like and then refuse to be treated. Makes me wtf they even bother being admitted. Waste of time and country's resources. Pisses me off further when I think abt my high taxes paid to this place is spent on these people who are nothing but society's parasites and burden.

Completely blew my top over a scolding from a senior doctor who stays in the lab 24/7 and has COMPLETELY no idea of how the hospital actually works. I was condemned by this doctor for something I had no control of (makes me boil thinking abt it), and even though I'm a junior doctor, I will not tolerate being yelled at and taking raps for others. Hence, I told him off over the phone, stressing the fact that the error is something that I had no control of, and I did no wrong to begin with, hence, a chance for me to push blames on others (which he claimed I did) will not even exist to start. And I also told him that this error should be an issue which he, as a senior staff, should address to the hospital instead. Anyway, this issue became quite huge since my Consultant was contacted abt it. Whatever it is, I will stand firm and insist to the end that the error wasn't within my control. My Consultant is a very understanding person, and I am sure that he'll see where I'm coming from.

I'm not angry abt this anymore. But the way this hospital is managed is poor. It's a good thing that I'll be leaving soon. It frustrates me enough to do silly things when I know it is silly, but have no choice, since it's hospital policy and management. All talk, but nothing productive is ever done in this place. Typical angmo way of working. Bah!

***********

It's Dearie's first day of work today, and this poor darling of mine already has to work overnight. I wonder how he's coping now without sleep, and it does worry me a little abt him driving home later.

Been missing him a lot, but we've been really busy with our stuffs everyday that by the time we get to talk to each other, we would have been exhausted.

Dearie told me that he misses our days together in University, and he wished he had done his undergrad in UK so that he would have known me earlier and if that happened, he would be able to spend more time with me, take care of me, and not let me spend years alone abroad.

Even though we had unhappy memories, I still miss the days we lived in the same building. I miss how he would message me every night at 10pm on MSN in the beginning. I miss how he would pay me surprise visits. I miss how he would wait for me at the bus stop after I finish lectures and go to the supermarket with me on our way home. I miss staying in his room talking to myself while he does his work. I miss how he would frantically try to find me in town when I ran away after quarrelling. I miss how he would take me out for a stroll around town very late at night, and enjoy a bottle of orange juice and a hot packet of french fries, when I am tired from studying. I miss how he took great care of me when I was very ill for 2 weeks. I miss how he would stay by my side to coax me to sleep. I miss waking up, finding him next to me. And I miss the night he told me that he'll never let me be alone again.

Ancient and modern-day practice of Medicine

The famous "Hua Tuo" suddenly came into my mind while I was going into a daze after a long day's work. My family mentioned his name once when I was very very young, telling me that he's a famous physician in Ancient China, but I never asked more about him. Neither did I bother to find out more even after reading this Chinese textbook story about him doing a surgery for General Guan Yu when I was in primary school.

I have always been extremely proud of being Chinese, and am even more proud of it after coming to the UK abt 6-7 years ago. Having a bf from China influenced me further, and from someone who didn't appreciate the Mandarin language much and not being used to speaking it, I have gradually grown to love my own mother tongue. Being a Singaporean Chinese, my mandarin proficiency cannot be compared to my bf, who knows quite a bit abt ancient China's history, read numerous famous Chinese literature, able to recite poems and write profoundly. Also, not forgetting, even my pronunciation isn't right to begin with, and Dearie had to make me repeat it after him just to get my pronunciation right. You bet it is a chore for him, and many times, he ended up laughing and giving up.

Due to my increasing interest and love for my own roots and ancestry, I have been taking out the map of China which Dearie gave me, and trying to locate places, especially where my grandpa came from. The map wasn't detailed enough to let me locate the village which grandpa mentioned before, but at least I roughly know where it is in China. Just by looking at the map, it made me happy.

I have also tried to read Chinese poems, but can never remember them. But it does keep me happy just by reading it and trying to appreciate the beauty of the language.

Anyway, back to Medicine.

I did a search for Hua Tuo since I wanted to know more about him, and I am indeed impressed! He's well known for creating an anaesthetic called "Ma Fei San" using the combination of herbs and wine. He's the first person to create this, and the Westerners only started using anaesthetic 1600 years after the "birth" of "Ma Fei San". Hua Tuo was also an expert in acupuncture, and the famous "Hua Tuo Jia Ji" which he discovered was named after him. I did some reading on this, and learning briefing about the angle of insertion, the distance away from the spine and the depth of insertion were really interesting. It's amazing how these 3 can make a difference and the theory of it all.

I also read abt the descriptions of some of Hua Tuo's encounters. There are 3 most commonly mentioned ones. The first is about him getting a patient who was really ill with abdominal pain to adminster "Ma Fei San" before he did an abdominal surgery on him. Hua Tuo removed the diseased part of the bowel, sewed up the wound, and applied some ointment on it to encourage recovery. The patient recovered soon after. The diagnosis is our modern day appendicitis, and what he had performed during then was what we know today as appendicectomy.

The second is about his expertise at diagnosing if a woman is pregnant and being able to tell the sex of the fetus through feeling the pulse of the pregnant patient. There was a description of him diagnosing a retained fetus in a General's wife who had a miscarriage. The General's wife had injured herself during pregnancy and as a result, had a miscarriage. The baby delivered was dead, and caused extensive haemorrhage. However, after the delivery, she deterioriated in her condition, and Hua Tuo came to a conclusion that the lady had twins, and the 2nd fetus which has died within her, has not been delivered, and therefore causing her deterioration. He did all this by feeling only her pulse. True enough, with instructions given to another lady, the dead 2nd fetus was removed by hand from the General wife's body.

The thired encounter is about him using acupuncture to regain a patient's ability to walk.

I am amazed by the above, because Medicine is those days are primitive. Everything was done by through thorough history taking and careful examination. The examination skills of the physicians then were so brilliant that diagnoses can be made, without the need of any other invasive or sophisticated investigations. Medications given were from nature.

But in modern day medicine, even though we still take histories and examine patients, our skills are no where comparable to physicians of those days. Our examination skills aren't as fine as theirs, and I'm sure our history taking aren't as detailed as them too. We are able to come up with diagnoses and differentials, and be highly suspicious of whatever, but we cannot confirm anything for sure unless we have blood results, xrays, and other types of sophisticated investigations. We have become so reliant on today's technology that doctors have lost quite an extent of skills we should possess as a true practitioner. We also rely so heavily on pills and medications produced by pharmaceutical companies, that we have neglected what nature has to offer (TCM still uses herbs, but they have turned quite commercialised now too). It would be extremely interesting to see how a modern day physician survives if he goes back to the past, into the ancient days where there's nothing to rely on except history and examination.

I have always been amazed about how fascinating ancient medicine is, and TCM is something I'm quite interested in even though I don't have any knowledge of it. I just personally feel that traditional/ancient medicine holds a lot of value, and it would be very beneficial and handy.

A brilliant physician who will send others going "wow" in today's medicine is one who can diagnose a rare disease after doing all types of investigations and treating it. But I think a true physician who really deserves saluting is one who can diagnose diseases (common and rare) without a doubt and without any investigations and treat it successfully with plain herbs.

Unfortunately, I don't think such a physician exists now....or perhaps...maybe they still do in the extremely extremely rural places which I believe must be still practising proper medicine primitively.

Days of self-doubt

I must admit that I have grown more confident of coming up with diagnoses and drafting up a management plan. My confidence has also been gradually building on reviewing patients whom I have no clue about. But despite all that, there are still days whereby I feel completely crap and doubt my competency.

I reviewed a patient today as the nurses were concerned about her being very dehydrated. She is VERY peripherally shutdown, and it was HELL trying to cannulate her. She didn't look very unwell at all, and even though her oxygen saturations weren't detectable, she wasn't huffing and puffing. Blood pressure and temperature was fine. Hence, I had no reason to suspect anything more than dehydration after examining her. I focussed AAAAALLLLLLL my thoughts on cannulating her so that she can have a drip going in fast. If it was of any consolation, I actually managed to cannulate her halfway before her veins collapsed...lol. I gave up after a few attempts and seeked senior assistance.

Being mega busy today and having my pager going off once every less than 5 minutes, I missed the fact that this patient had a temperature spike yesterday even though it was shining right into my face. If I had concentrated more, the thought of sepsis and a pending septic shock would have come into my mind. Dehydration wouldn't have just been my diagnosis, even though it was correct in a way.

Fortunately, I did pester my senior to review her, and he had agreed with me that this patient is very dehydrated and fluids are needed to be given quickly. However, that spike triggered thoughts of an impending septic shock even though she looked deceiving well. More investigations were being done, and the results were so bad that she was transferred to the high dependency unit immediately. A central line was placed instead since my seniors thinks she's impossible to cannulate after they failed to do it too.

Then not too long later. A new patient who was seen by the Registrar on call arrested in the same unit. I ran quickly there. Good thing I wasn't the first doctor there, or else I would have been thrown completely into a fluster. This patient was so unwell on admission that he was sent to the high dependency unit immediately, and before he arrested, he had numerous lines placed into him already. It was a complete mess around him with so many leads, wires and lines around him. It was impossible to tell which line is for what in a critical situation. Everything was in control with the presence of the ever-so-calm anaesthetists (I think I should never ever be an anaesthetist) and all I did was CPR. First time doing it on a real proper and goodness, it really isn't as easy as how I thought it should be. I don't think I'm a weak girl to begin with, but it is tiring compressing someone's chest. I was in sweats already by the time I finished one cycle.

My mind was in quite a blank for a good 2-3 seconds when I arrive. All I know when I realised that it's asystole was CPR, after the airway, breathing and circulation are secured (if that's of any consolation). I think I do know what to do (will be a separate issue if it's something shockable since I think I've gone rusty on when to administer what meds after how many cycles of CPR) if I was the first person to arrive at the scene, but I definitely would go blank for 2 seconds first. I will need to be really calm the next time if it happens. I guess I'll need to have more cardiac arrest experience (real ones of course). Anyway, this cardiac arrest did make me feel a little crap at the end too.

Argh. I will need to revise more and consolidate everything more. 2 more mths to end of housemanship, and I don't think I'm worth being forgiven if I can't even manage a patient well.

6th June - Dearie's Bday. And he's received a brilliant gift this year. He's finally got a job!!! Am really really happy for him! It's not high-paying, but that's not our 1st priority at the moment. We're just extremely pleased that at least we can see some light somewhere, and we've finally taken our first baby step towards our future together. To us, gaining work experience is 1st priority, and when he's got enough experience, he'll find a way to make it to Singapore to reunite with me permanently.

He has been warned that he'll have numerous overtime to do, and will be expected to work during public holidays if needed. Looks like I won't get to talk to him much when he starts, and might not be able to go to Singapore to see me in a few mths' time. Sigh...seems like it's liking going to be me making a trip to China again the next time. If I do go there, shall make the effort to stay longer (Dearie and his family told me to stay for at least a mth!!!!).

Over the last few weeks, memories have been coming back of how I first met Dearie, our days in University, and how our life was like being flatmates. Happy & sad ones. Time has past really quickly, and we've been in a relationship for more than 2.5 years. It hasn't been easy, and over these years, we've grown so accustomed to each other and are aware of each other's good and bad habits. Gradually, he has grown to occupy a major place in my heart.

Despite having numerous big quarrels which have resulted in us being at the verge of breaking up, I still feel blessed in some ways. A friend of mine was confiding in me regarding his relationship with his gf, asking me if the rship was worth continuing. When I asked him how his rship with his gf was, his "I don't know" reply left me speechless for a while. That night, I asked Dearie the same question and asked for a truthful answer. He didn't hesitate for a second to say that it's good and said he feels blessed to have me. At that moment, I felt really blessed and loved. It isn't easy to get someone to say his/her relationship is good without hesitation.

******************

One of my patients died yesterday, and again, my tears rolled whilst I was at the ward desk doing some paperwork. Having looked after her for 2 months, even though she has hardly spoken to me due to her dementia, I still felt a little for her. Even though she was very elderly, she was like a little girl, never failing to hug her soft toys when she's sleeping. What made me cry yesterday was when I heard her husband talking to her dead body. 60 years of marriage (I hold high respects for angmo couples who manage to keep their marriage this long since the divorce rates for them is so high) and during her 4 mths' stay in hospital, there was never a day he failed to come to the hospital by bus to visit her even though he lived really far away. She died just a minute after he left her room to get a cup of coffee. He spent a long time staying next to her corpse, talking continuously to her as if she was alive. He must have endless things to tell her. As an onlooker, I could feel his pain and his deep love for her. I felt a little crap for not getting her well, and I did reflect for a while if it was justifiable to terminate treatment because she was deteriorating suddenly.

A Consultant told me today that studies have shown that doctors are overly optimistic because of their goal of saving a person's life, but what I can never understand until today is...when is it the appropriate time to set one's foot down to make the decision of terminating treatment? Whenever my patients die after their treatment has been terminated due to a sudden change in their state to a level whereby we believe that they will not make it, I cannot help but wonder if they would slowly getting better if we had taken the treatment to a more aggressive level. Dad told me before that it is better and more humane way to terminate treatment because by giving more aggressive treatment, I will be prolonging the patient's sufferings further when finally at the end, the patient might not even survive. He's right, but somehow, part of me feels regretful and can't help questioning if the situation could have been different if a different management has been done. I guess in some ways, I am selfish, since I'm placing saving a patient with all that's available above how the patient is actually feeling.

P.S.: Hey Julian, if u're reading this, perhaps it's a good thought before your bedtime?

Back to work

I slept really well last night, and got up at abt 6+ this morning.

Was still feeling pretty lazy, but decided to force myself to get up. I reported for work at 7am this morning. :)

It was nice seeing familiar faces, and having colleagues from different teams asking me how my annual leave went. It was also nice to have my own senior telling me that I was missed very much by the team because of the lists I make everyday for them.

Work does aid to make me feel happier abt being back. My patients are still making me laugh with things they say and do. It's wonderful seeing my old patients who are still staying in after I've went on leave for 2 weeks, smiling and greeting me as I was doing the ward round today.

2 more mths to go...I shall press on.

Jet-Lagging?

Never had this problem before, but now I know what it is all about..sigh..

Despite being in the A380 on my flight back to the UK, I still didn't manage to get much sleep at all. No doubt I'm a piggy and I do sleep anywhere (yes, I dozed off once while sitting on the toilet bowl doing my business), but somehow, I couldn't get to sleep at all in the plane. Or maybe just a little bit of snooze before touch down. The entertainment was brilliant, but that wasn't the main reason for keeping me awake.

Snoozed more whilst on the coach and train back to where I currently am.

I'm not as happy as how I returned to this place like the last time, and the first thing I did after unpacking my almost-empty luggage and showering is to hide under my duvet, with music playing in the background.

Memories started streaming back to my last years in University whereby I'll end up spending most of my time in Dearie's room singing and talking to myself whilst he's busy doing his stuffs. And then waking up to find food on the table if I happen to doze off amongst my piles of books and notes.

I slept a good 5 hours after ending a call with Dearie. It's comforting hearing his voice, especially when I haven't been feeling well these few days. Maybe it's the lack of sleep (I couldn't sleep much during my few days' stay in Sg) which has caused my immunity to plunge, causing some cough to start. Been feeling quite nauseous for a few days too. I wished Dearie was here to give me some TLC.

Ok, time to call him again. Hopefully he's woken up.

And work starts later...sigh...

Returning for the LAST time (hopefully)

I shall be returning to the UK for the last time (hopefully) tonight. Funny enough, it doesn't excite me at all despite knowing the fact that I have only 2 months more to go before I earn my "licence to kill" and bid a permanent farewell to a place I've lived in for more than half a decade. Is it the post-annual leave syndrome playing up? Or is it the thought of the piling things I have to rush to do once I get back? Or is it this weekend's on call which I so dread to do? Or is it an unexplained loneliness I still get within despite having friends there? Perhaps..it's a little of everything.

With a bank holiday to extend my annual leave for one more day, I have already gotten a good bargain, and was able to spend more time than I could have asked for with Dearie. But this is never enough I suppose. The thought of being only able to see him a few months later again saddens me very much. I hated the idea of having to leave him so much that I was hoping so much to miss my flight. Anyway, I'm appreciating the effort he's putting in to try and make our regular separations temporary. I'm telling myself that even though we'll still be separated after I've come back to Sg, it will be better than being half the world apart like how we are at the moment. Family, friends, and the hectic schedule at work will ease it up. Plus no more time difference, and I'll be able to cheer myself up with silly childish thoughts like "He must be having lunch while I'm having mine" and "He must be getting ready to sleep now just like me."

This holiday has been good for me both at home and in China. My little puppy has made it a difference for me, giving me something to look forward to the moment I wake up, to whenever I feel alone. He's still too young to be climbing stairs, but I'm sure when he's older, he'll become a frequent visitor to my room. :)

Feeling damn sianz...and I'm not in the mood to pack my luggage at all (hate packing luggages after all these years) even though there's hardly anything to pack. Just wanna lie in bed and rot away.