Thomas Willis

Gotta love the OCHM for these little gems of wisdom.

Thomas Willis is one of those happy Oxford heroes belonging to Christ Church College who hold a bogus DM degree -awarded in 1646 for his Royalist sympathies. he had a busy life inventing terms such as “neurology” and “reflex”. Not only has his name been given to his famous circle, but he was the first to describe myasthenia gravis, whooping cough, and the sweet taste of diabetic urine. He was the first person (few have followed him) who knew the course of the spinal accessory nerve. He is unusual among Oxford neurologists in that, at various times, he developed the practice of giving his lunch away to the poor. He also developed the practice of iatrochemistry: a theory of medicine according to which all morbid conditions of the body can be explained by disturbances in the fermentations and effervescences of its humours.

 

Endocarditis! (the song)

Verse 1:
Girl, please excuse me if I’m coughing kinda strong,
but Ive got a cavitated nodule in my lung,
My tricuspid is damaged, platelets-fibrin might thrombose.
That vegetation’s got it looking just like a jungle.

oooh, ooh,
Acute from staph aureus if you’re an IVDU
oooh, ooh,
A fever and a murmur, baby, let me here you go:

Chorus:
Endocarditis! Changed hemodynamic flow
Endocarditis! Got a tender Osler’s node,
Endocarditis! Ventricular septal hole,
Endocarditis! Endocarditis!

Aureus, viridans,
epidermidis, enterococcus

Verse 2:
Girl, please excuse, but my heart disease predisposed
My mitral valve is prolapsed and my arteries sclerosed,
strep viridans and group D giving me a subacute,
Bartonella culture negative you’ll never even know!

oooh, ooh,
Anaerobes can’t do it cuz they don’t adhere to you
oooh, ooh,
A fever and a murmur, baby, let me here you go:

Chorus:
Endocarditis! Changed hemodynamic flow
Endocarditis! Got a tender Osler’s node,
Endocarditis! Ventricular septal hole,
Endocarditis! Endocarditis!

Immune complexes, heart infection,
emboli to brain, skin, and lung,
Janeway lesions, spleen infarction,
Mycotic aneurysm.

Roth spot, petechiae
hematuria, arthritis

Chorus:
Endocarditis! Changed hemodynamic flow
Endocarditis! Got a tender Osler’s node,
Endocarditis! Ventricular septal hole,
Endocarditis! Endocarditis!

Affix Passport Photo Here

There was a bit of furor last night trying to suddenly gather references for my placement at Khoo Teck Puat Hospital during my summer break. The Girlfriend found it infinitely amusing that I’m applying to work there and already alerted her pharmacist friend in the gen surg ward of my January plans. I’m actually quite fired up about all the attachments I’ve got over the holidays. I filled in the application forms right away, though I must say, 3am form filling makes for very dodgy results.

Say, for example, the little box which said “affix passport photo here”.

The Girlfriend is one of my references, though we were having a conversation about whether it would count against me since she had left KTPH a few months ago. I highly doubt so though. I was sorely tempted to list her occupation as “muffin gnome”.

All these traveling to different hospitals to do attachments is a truly fascinating prospect I hope to be able to experience some time.

The house hunt over the weekend turned out to be another bust. Shall not go into all the horrid details, but basically I got screwed over by real estate agents again. It’s almost like they’re trained to make you feel like crap and be terribly rude. My parents have picked up the hunt instead and almost instantaneously found 17 houses without so much as an eye strain. Granted, they picked some real dodgy ones (a converted garage that looked vaguely like the scene of a horror movie. My mom even said she thought it looked like a scene from The Shining and that’s why she picked it). They also picked up some gems which I would love to rent provided I can find others to share it with. Think that will be an immense challenge at this stage though.

Study is going painfully slowly, though I do get my short bursts of motivation in between the long lulls. I really don’t know how to begin studying for this exam and as a result I’m going about it in a “bird shot” fashion, studying anything and everything with no real structure to speak of.

Let’s end with pictures from the internets.

Is your child’s pediatrician gay?

Is this lady serious??

=\ A big part of me is hoping that this is a joke text someone put into a computer. That America can’t be that depraved. That people can’t actually believe that homosexuality is contagious.

The world is home to some really strange people…

Distress and Career Satisfaction among 14 surgical specialties

To start the post off:

Now we all know how to get overnight celebrity status.

I came across an article yesterday which, oddly enough, detailed the stress levels and happiness of surgeons from different specialties in a paper titled “Distress and Career Satisfaction Among 14 Surgical Specialties, Comparing Academic and Private Practice Settings”. (you might require a medscape login for this)

Long title, I know. It was published in the Annals of Surgery 2011, and posted onto Medscape last week. Not exactly ground breaking stuff, but very interesting a read anyway. Basically, the study found that Academic surgeons (whatever that means) had a lower rate of burnout than surgeons in private practice. It also identified that the speciality most at risk of suicide ideation was vascular surgery. Surgical Oncology (which currently piques my interest) had a lower mean age (49.9years), and the highest proportion of women (26.4%). They had a high workload, and lower nights on call. They had a lower burnout rate (36.1%)m and a positive depression screen rate of 24.3%.

However, they did report a 55.2% rate of home/work conflict, with a suicide ideation rate of 4.9%. Despite all this, they had a higher level of career satisfaction (demonstrated by the percentage of them who would not want to be a surgeon again, and those who would not recommend a medical career to their children).

Interesting.

Here’s a table.

Belated Birthday Weekend

So it’s been a week since I last updated this blog, and lots has happened since then.

Just as I had typed my last post, something rather miraculous happened. I actually had a birthday dinner. It was something I totally did not expect and I’m very grateful that my friends in school took the time to come have dinner with me on that Thursday night. Extremely thankful to those who organized it as well. And I was all ready to just sit at home and study the night away.

It was a simple enough gathering at La Porcetta, quickly organized during that morning’s ward rounds. Despite the late notice, people still made the effort to come. That dinner did more for me than they can ever imagine. I felt like the immense sadness and depression that had been building up over the last few months were just washed away, even if just temporarily. For that night, I was happy. And that was all that mattered to me.

The birthday Friday itself wasn’t much to shout about. It started with the traditional mee sua which we have every morning back home. Though, since I’m here alone, I make my own little bowl. My dad, who was celebrating his birthday as well, had his noodles and we exchanged pictures (which I instantaneously regretted. Seeing how mine looked very non-delicious)

PAPA’S

MINE

Tastes the same! I swear it does!

Either ways, class that morning was interesting, with a revision of advanced life support practices. And there were brownies! I love brownies. And I got my first birthday present of the day from Jess – a box of extremely yummy chocolates.

I then had to make my way to the city to view houses and the like. Real estate agents can be absolute pricks. The first was being an absolutely immature child on the phone. I was 10 minutes late for the inspection since the house wasn’t on my GPS and I got lost. I then took 15 minutes to try to call her, with her only picking up her cell phone when I rung through the office. Then she proceeded to say she was waiting 15 minutes for me. Then increasing this time 3 sentences on to 30 minutes, and so on. A mathematical conundrum I’ve only witnessed before when I was teaching Primary 3 mathematics.

Later in the day, another real estate agent stood me up. His email clearly stated 11.30am, but he didn’t show up at all. When I called him, he said that it was 12.45pm and the email was “inaccurate”, without even apologizing for the mistake. Certainly two agents I will not be working with anytime soon.

Dinner was with Sara at the new Taiwan Cafe along Swanston. I’ve heard some good things about it and was quite keen to try it out. Though when I got there, the queue was quite…. Tumorous.

And this was before the shop even opened for business. I queued for about 20 minutes before the store opened, then had to try to push my way in for another 15 minutes, before being shut just outside the door and given a queue number to come back in 30 minutes.

Well, that’s all fine I suppose. I was expecting spectacular things from that restaurant now. We tried ordering some Taiwan street snack staples like the oyster mee sua and oyster omelette, but neither of those were available. So we ended up with some noodles, pan fried pork dumplings, XL chicken cutlet, tofu with century egg and intestine mee sua.

The noodles were pretty tasty. But the dumplings were tough and the filling sort of fell out the other side when I took a bite out of it. And the chicken cutlet was quite bland and tough. And, to top it all off, the tofu had live maggots in it.

Yes. Live. Maggots. wiggling about. And burrowing their way into the eggs.

It was disgusting. So we left shortly after that, not really caring that they had forgotten our mee sua as well (which they attempted to charge us for, along with the maggot tofu).

The surprise of the evening was when Sara appeared with flowers that The Girlfriend had requested for her to help buy for me. 25 of my favorites. Thank yous to both Sara and The Girlfriend for going through all that trouble.

Sara even gave me new Domo slippers. Goodness knows I need new ones with my old pair pretty much ripped open.

So that was the birthday weekend. Not very exciting, with quite a few let downs. But what really mattered most was that I felt like people cared about me. And that meant more to me than anything else.

Updates and Soup

The older you get, the more awkward birthdays tend to get. I finally turn 25 on Friday. But I’m not as excited as I used to be as a kid. Mostly because I don’t celebrate it with my family like I always do. For the entirety of my life, I’ve always celebrated birthdays with my dad who shares the same birthday. But here, I feel so disconnected from the world. Even more awkward this year when I don’t have many close friends at LRH.

I’ve got a morning class to attend on Friday, then I’ll probably drive down to the city right after to view some houses alone in Clayton. It would probably also entail lunch alone, which gives me the luxury to choose whatever I’d like to eat. And my mind just keeps going “Claypot King Claypot King Claypot King”. Dinner would be with Sara at the Taiwan Street Food place somewhere in the city. I hear there’s an immense queue for it though, so I might end up with much of my evening by the pavement outside the restaurant.

Oh yes, I forgotten to mention. I’ve managed to get a swap into metro from Frankston. Though that entire day of hectic rushing left me seriously confused whether to be happy or sad about it all. Shan’t / Can’t / Shouldn’t talk about it.

It’s nearly the end of the semester, at last. And I’m looking forward to my metro placements next year. Though I just got an email from one of my swappers within metro placements that she no longer wants to trade my Eastern Health for her MMC. I’m sure I can make do. I’m looking at houses in the Clayton area, which proves to be both a painfully nostalgic and tiring exercise. Why do we have to keep pestering the estate agents for details and inspection times? If anything, I’d be happier with more applicants for the properties.

In an effort to spice up my week, I went out and got some seafood today to make a rather elaborate sounding seafood soup, stocked with mussels and squid and scallops. And as a dipping bread, I pigged out with a single serve garlic and cheese pizza.

I know… Look at all that oil. I still have lots left for tomorrow’s breakfast/ lunch. But it was shockingly tasty, albeit a tad on the salty side. I suppose I can drown it out with a bit more water. Tomorrow’s dinner will be mee sua so I’ll have some leftover for the traditional mee sua breakfast on Friday morning.

With the upcoming holidays, it’s made me start thinking about overseas attachments and the endless possibilities. A short search on Google has linked me up with Work The World, and Projects Abroad, companies which specialize in linking students up with overseas placement projects lasting between 2 weeks to a couple of months in various countries around the world. Their placements include Argentina, Ghana, Nepal, Sri Lanka and Tanzania (Work The World), and an even vaster array like Combodia, Brazil, Bolivia, Fiji, Ghana, Mexico, Mongolia, Romania, Peru, Thailand, Vietnam, South Africa, etc etc (Projects Aboard). Note: Projects Abroad is not only for meddies. They do projects in nursing, teaching, physiotherapy, sports, archeology, building, journalism, etc etc etc. Quite a cool sounding program really.

I’m particularly interested in going to Nepal for a couple of weeks, though probably next year in June or so. Being in Year 4C would also put me at a nice spot in my medical training career to be shipped off to somewhere, no strings attached, and do some intensive learning.

That being said, it must be mentioned that some students tend to think that going to a developing country equates to getting a free reign on whatever they’d like to do. This is not true. Programs are quite well tailored to your individual interests and you’ll be paired up with a teaching physician who may even have an entourage of his own local students. It’s a great way to learn about the cultures in other countries and their medical school system. Not to mention the diseases that you’d probably never see that much in a developed country like Singapore or Australia.

Another option for students in Australia would be to join the Royal Flying Doctors’ Service. They take on student placements as well and fly out to the really inaccessible bits of Australia where healthcare can’t seem to penetrate. Though this is based in NSW and QLD, so it’s a bit of a hassle for students in other states. Then again, it’ll be closer than flying to Nepal.

Righto… So that’s that for overseas placements. At the end of the day, it’ll still be subject to approval from those back home. Not even sure if I would be allowed to go at the end of the day.

Black Tactical has restocked its Magpul M4 Carbine Collapsible Buttstock. Hope they’ll still have some when I get back home in a month’s time. But for now, it’s time to get back to work.

The sharp decline and slurred upstroke

So let’s begin with some theme music.

Placement results were out sometime last evening, pretty much a culmination of my rather horrific day. Despite putting Frankston pretty low on my preferences, that’s what I got. Really not happy about it, but I suppose at this point, there’s nothing I can do. I still think there’s something fishy about how there is a disproportionate number of international students there, both grad and undergrad (most of us put Frankston as close to last choice). But conspiracy theories won’t do anything to help my situation. I’ll be stuck in Peninsula Health for an entire year.

I was really looking forward to living in the city at last, after 2 years of countryside. I’m really not a country person and my need for a 7-11 close by is almost at ravenous levels. But alas, Frankston won’t have a 7-11.

The placement decision was like the sour icing on top of my shit cake. Begun the day late for rounds. Then went to practice OSCEs which I didn’t get to finish and hence got a fail mark for. Then went home to find out my idol Steve Jobs passed away.

Today was a little better and gave me a small sliver of hope in the distance. A friend who just did the past year at Frankston mentioned that he commuted from Clayton and the travel time was only 30 minutes door to door. Plus little to no traffic since he was driving against the flow of morning traffic. I’m considering living in Clayton since it’s only 10 minutes further than the other place I was thinking about. And I would have the option of living there for 2 years instead of moving again at the end of next year.

Additionally, I just got an email from the surgeon I was attached to during my June break, confirming my second attachment with him at the end of the year. Just will have to drop him an email again when I’m back. His email was like a shining light through all the crap on my day.

Here’s something medical for the day. A graph detailing your risk for developing lung cancer.

And a series of pictures of people riding the Splash Mountain ride in US

Bloody Mary Steak

Just as a side note, the further away I get from age 21, the more I feel like one of those old ladies who refuse to acknowledge their true age when I shop at Forever 21.

So tonight I made Bloody Mary steak.

I actually didn’t expect it to taste as nice as it did. Marinated for 2 hours in a strange mixture of tomato juice, tabasco sauce, horseradish, minced garlic, and some lemon juice. Tasty tasty tasty. Sat it on a bed of “grilled in my frying pan” shallots (which are surprisingly sweet when cooked). I still have another chunk of this skirt steak in the fridge all marinated and ready to go for my lunch tomorrow.

I discovered recently that not only do brown onions make me cry, but so do spring onions. So I look a little bit mental when I’m chopping onions, leaning back as far away from the board as I can. Lots of methods have been proposed to stop one from crying in the process of cutting up onions. This includes:

• Chewing bread while cutting
• Chewing gum while cutting
• Wiping the blade down with a lemon before cutting
• Cutting underwater
• Wearing goggles

Why do onions make us cry? ScienceBob has the answer! Basically, the cutting of the onion releases sulphur gas, which, when mixed with the moisture in our eyes, creates a pretty weak acid that irritates our eyes. This causes them to water. Either that or the onion is just a very hurtful food.

Speaking of meals, Thursday there will be yet another Year 3B meddies gathering as everyone makes the final trek back to Traralgon for our last Back To Base this year. There are promises of a BBQ and alcohol (which I have developed a rather severe distaste for. No I do not have Hodgkin’s lymphoma.)

All this western type diet is going to make me enormous at some point.

Didn’t get to mention it on Sunday, but happy 8 months! Here’s a picture just for you!

Sluggish Mondays

I had a horrific night really, tossing and turning right up till 6am, falling asleep for just half an hour before my alarm went off. So I did the only sensible thing. Smacked it off and went back to bed. That only clocked me 4 hours of proper sleep before I woke up again and now I really feel the horrible effects of an unplanned lack of sleep.

Some good came out of today I suppose. I got my ninja bunny bento bag in the mail.

It’s a tad too small to fit my bento box horizontally, so my bento has to stand. not sure if that’s advisable though. I have to make sure I don’t have anything with sauce in there before trying that. Tomorrow’s lunch will be some california maki things, a small serve of seasoned spinach, some octopus sausages, and one salmon maki.

Tomorrow I’ll also be trying out a new recipe – The Bloody Mary Steak. Sounds refreshing. Going to top it off with some watermelon and basil lemonade. Not sure how that’s gg to turn out really.

In home news, my dad is doing better today. The information I’m getting is heavily filtered through my mom so all I know is the drain tubes are coming out tomorrow morning and he’ll be discharged shortly after. Other than that, we’ll just have to cross out fingers and toes, and hope this would be the end of this terrible saga.

Good lord I’m sleepy.

It’s a strange (and borderline socially awkward) time, browsing the internet for a birthday present for myself. I’m considering checking myself into a nice hotel in Melbourne for a couple of nights to enjoy a nice room, nice bubble bath, and a pool. Either that or a Nerf gun which I can spend my year end holidays modifying. Might end up with a room full of strangely modified Nerf guns.

Speaking of my room, my house will be nearly done by the time I return to Singapore next month. Due to the expansion of the bathroom on my floor, my room has suddenly become the smallest of all, and the room I relinquished to Hua has become the biggest. My bed had to be moved to a dark corner, leaving a rather large space in the middle of my room. I’m considering getting a really comfy chair and a small quaint rug to put in the middle of my room so I can sit and play guitar or listen to music. Chillax-y room sort of feel.

I need sleep…