Vampy's Weblog - Life of a Medical Officer

Hmmm... I've been gorging myself on the best durian pastries in Singapore. Durian puffs, durian oreo cake and durian and brownie choclate cup made by the fine pastry chefs in Goodwood Park Hotel. They also make the most fabulous Durian mooncake and Green Tea Mooncake during the Mooncake Festival. I always make it a point when I'm back in Singapore to eat my fill of durian patries from the said hotel.

Scrumptious Durian Puffs - light and fluffy puffs and creamy durian paste

Durian Oreo Cake (left)- This is the ultimate durian cake... Literally the cake is made from durian with only 2 thin layers of biscuit crumbs.
Durian and Brownie Chocolate Cup (right)- Combining 2 of my favourites - Yum!

Now having satisfied my tastebuds, I have to think about more serious stuff like what network of hospitals should I choose and in which order of preference for my internship application. I'll have to decide that soon. The application starts sometime end of April. How in the world does one make a decision when practically all of us have only had exposure to at most 2-3 networks.

How do I know whether the hospitals in other networks are supportive of their interns or for that matter doctors? What is the working culture like in those hospitals? Is the surrounding suburbs/ areas safe to live in? I do not wish to travel too far to get to work...Realistically, the last thing I want to do after one night of on-call, is to drive 1 hour on the freeway sleep-deprived. How about amenities around the area? While I'm not someone who goes shopping everyday, I do need to feel that civilization is around me at least once a week. I mean in the best case scenario I get allocated the same hospital that I have been training as a med student. It's in a pretty safe neighbourhood, accomodation should not be an issue, just one train stop away is a major shopping mall. It's not that far from the city. But what are my chances of being allocated there for intern? Therefore I need to think about alternatives as well. Well, wish my luck!

Holidaying (hmm, it's actually a word). Anyway, as title suggest I'm finally on holidays. I had submitted my assignments for my term and am waiting for the verdict (hopefully a favourable one). Pretty much, I have been bumming around... catching up on sleep... eating... playing Wii... watching DVDs. However, now that holidays are here, it also means that in a few weeks time I'll be flying back to Sydney to complete the rest of my final year.

As my student life draws near to an end (crossing fingers), there is a mixture of both anticipation (at least the part of no exams for the next couple of years and finally earning some money) as well as anxiety. While it it true that as a junior medical officer, I do not make any final decisions about a patient's treatment, the fact remains that the patient is under my care. The idea that someone's life is in one's hands can be quite fear inciting.

Well, enough of that for now... I was YouTubing (not a word) and found this great a Capella group called "Straight No Chaser" founded by students of Indiana University. Have a look... I'm contemplating getting their DVD...

12 Days of Christmas

It's so hard to say goodbye to yesterday - last song performed by the original members of the group

Sitcom Medley

I was asked to observe a patient undergoing a new therapy that is available for rehabilitation of stroke patients today. It's called constraint therapy. As the name suggest, the therapy encourages the patient to use the affected limb rather than use the unaffected limb in daily life. This is achieved by constraining the unaffected limb.

The patient I saw had a stroke several years ago. Today was the 6th day of a 10-day programme. As I was observing him go through the exercises to help him gain control and use of the affected limb, I was suddenly struck by the amount of effort and concentration needed for him to achieve the most simple movements which we all take for granted. For example, how many of us would be typing on the keyboard and reaching out to grab a cup of water to drink.

That action of extending the arm, manipulating our fingers so that they have a firm grip of the cup, then withdrawing the arm back towards the mouth while still maintaining a firm grip of the cup and ensuring that the cup does not tilt and finally placing the mouth of the cup on our lips takes maybe a few seconds to accomplish.

For a stroke patient, those series of actions will take probably a couple of minutes to achieve. With each movement, the patient needs to concentrate on the task, will his muscles and nerves to fire correctly. Make fine-tuning adjustments to prevent water from spilling out, before he can have his cup of water to drink. While I can see that as the afternoon wore on, he is becoming fatigue, he refuses to give up on any of the exercises he was asked to do and was determine to improve his control.

I must also praise the physiotherapist for her amazing patience and never-ending encouragement. No matter how many times, the patient would drop the object or forget to move the affected limb in a certain way, she never once became agitated. In fact, each and every time he completes the task, she would say "Well, done!". That is the epitome of what a great health professional should aspire to be. I hope that someday I can achieve her level of patience.

Whee! I got my Wii a couple of weeks ago... (Sorry for the corniness). I manage to play some Wii in whatever spare time I have. I must say it is quite a good workout... which in my case is probably a good thing. I have been increasingly paranoid about having a heart attack or a stroke one of these days due to my lack of exercise. I know that I should probably to doing more exercise in view of the fact that in less than a year, I would have to encourage patients to exercise. How hypocritical of me if I don't exercise and yet ask the patients to exercise. I can just imagine this situation:

Me: Mr. So-and-so, you have hypertension, diabetes and high cholesterol. You are at a high risk of heart attack and stoke. To reduce the risk, you must exercise regularly say at least half hour a day for at least 3-4 times a week.
Patient: Yeah? Really? I read somewhere that you don't exercise.
Me digging a hole right there and then with my fingers

In other news, my time at the community hospital is drawing to an end. I have enjoyed myself there - the doctors and nurses are great... Most of the patients are rather cute with their little quirks. I learned a great deal from my supervisor about common issues in rehabilitation as well as from the physiotherapist.

Finally, it's about 2 weeks away from Chinese New Year. After missing 3 Chinese New Year, I must admit I'm looking forward to it this year particularly the cookies and delicacies I'll be able to eat.. Yum! My friends are coming over to my place on the 3rd day of the new year and I guess we'll be spending some time eating as well as playing Wii.

I'm enjoying my time back in Singapore...all except the weather and the tons of assignments I have yet to finish. I'm halfway through my GP term and I realise that GP is not for me. I can't really explain it. I'm currently doing my second half of my term in a community hospital and I feel but more comfortable. I sat in on a couple of outpatient clinics which sees rehabilitated patients after they were discharged.

A couple really made an impression on me. The couple would be maybe in their late 30s or 40s. Unfortunately the wife suffered a devastating stroke that left her right side of her body contracted. She also is only able to communicate on a minimal level. As a result, she develop depression.

We needed to exam her and needed her husband to help us to get her to the examination bed. He was using term of endearment to talk to her and gently helped her onto the bed. It was then it struck me that the love of the husband for his wife is as plain as day. He could have left the marriage and remarry as he was still quite young but instead he chose to stand by his love. Even though his words may be falling on deaf ears and on occasions the wife may throw tantrums, he would still patiently talk to his wife.

In today's society, we have all heard about the rising trend of divorces and how couple split for the most mundane reasons, it is heartening to see that there are at least some couple truly believe in the marriage vows they took - "...In sickness and in health... Till death do us part."